Investigative MRI cholangiopancreatography for primary sclerosing cholangitis-type lesions in children with IBD

J Pediatr Gastroenterol Nutr. 2012 Sep;55(3):308-13. doi: 10.1097/MPG.0b013e31825bb3dc.

Abstract

Objectives: The aim of the study was to estimate the frequency of primary sclerosing cholangitis (PSC)-type lesions in children with inflammatory bowel disease (IBD) by means of magnetic resonance cholangiopancreatography (MRCP), and to investigate the association between a series of easily applicable data on the one hand and the presentation of such lesions at MRCP on the other hand.

Methods: Collected demographic, laboratory, and magnetic resonance enterography data from the records of 73 children with IBD were cross-sectionally related to the MRCP-based diagnosis.

Results: Around the time of MRCP, the distribution of IBD subtypes was 64.4%, 24.7%, and 11% for Crohn disease, indeterminate colitis, and ulcerative colitis, respectively. A total of 11 patients (15.1%) were identified with PSC-type lesions. Demographic and magnetic resonance enterography data were unrelated to the MRCP outcome. Biochemical abnormalities were of low prevalence (<50%) among patients with PSC. The abnormality prevalences of aspartate transaminase, alanine transaminase, and γ-glutamyl transferase were significantly higher in the PSC group, both at initial diagnosis of IBD and at the time of MRCP. Less-consistent results were documented for bilirubin and alkaline phosphatase, especially at initial diagnosis of IBD.

Conclusions: The abnormality prevalences of aspartate transaminase, alanine transaminase, and γ-glutamyl transferase were significantly higher in the PSC group. Nevertheless, PSC-type lesions frequently occur in pediatric IBD, even if the biochemical profile is hardly indicative of this probability.

MeSH terms

  • Adolescent
  • Alanine Transaminase / blood
  • Aspartate Aminotransferases / blood
  • Biliary Tract / pathology*
  • Biomarkers / blood
  • Child
  • Cholangiopancreatography, Magnetic Resonance / methods
  • Cholangitis, Sclerosing / epidemiology*
  • Cholangitis, Sclerosing / etiology
  • Cholangitis, Sclerosing / pathology
  • Colitis / complications
  • Colitis / pathology*
  • Colitis, Ulcerative / complications
  • Colitis, Ulcerative / pathology*
  • Crohn Disease / complications
  • Crohn Disease / pathology*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Magnetic Resonance Spectroscopy
  • Male
  • Prevalence
  • gamma-Glutamyltransferase / blood

Substances

  • Biomarkers
  • gamma-Glutamyltransferase
  • Aspartate Aminotransferases
  • Alanine Transaminase