Liver Enzyme Elevations Within 3 Months of Diagnosis of Inflammatory Bowel Disease and Likelihood of Liver Disease
ABSTRACT Background: Inflammatory bowel disease–associated liver diseases (IBD‐LDs) include autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and an overlap syndrome. Prospective unbiased multicenter data regarding the frequency of IBD‐LD in patients with pediatric inflammatory bowel...
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| Veröffentlicht in: | Journal of pediatric gastroenterology and nutrition 2014-09, Vol.59 (3), p.321-323 |
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| creator | Goyal, Alka Hyams, Jeffery S. Lerer, Trudy Leleiko, Neal S. Otley, Anthony R. Griffiths, Anne M. Rosh, Joel R. Cabrera, Jose M. Oliva‐Hemker, Maria M. Mack, David R. Rick, James N. Pfefferkorn, Marian D. Carvalho, Ryan Grossman, Andrew B. Hitch, Meredith C. Sudel, Boris Kappelman, Michael D. Saeed, Shehzad A. Faubion, William A. Schaefer, Marc E. Markowitz, James F. Keljo, David J. |
| description | ABSTRACT
Background:
Inflammatory bowel disease–associated liver diseases (IBD‐LDs) include autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and an overlap syndrome. Prospective unbiased multicenter data regarding the frequency of IBD‐LD in patients with pediatric inflammatory bowel disease (IBD) are lacking. We examined early alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (GGT) elevations in children diagnosed as having IBD and assessed the likelihood of IBD‐LD.
Methods:
Data collected from the prospective observational Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry enrolling children of age 50 (odds ratio 660, P < 0.0001). Of the 29 patients with IBD‐LD, 21 had PSC, 2 had AIH, and 6 had overlap syndrome. IBD‐LD was more common in patients with ulcerative colitis and IBD‐unclassified (indeterminate colitis) than in those with Crohn disease (4% vs 0.8%, respectively, P < 0.001).
Conclusions:
Elevation of both ALT and GGT within 90 days after the diagnosis of IBD is associated with a markedly increased likelihood of IBD‐LD. Both ALT and GGT levels should be measured in all of the pediatric patients newly diagnosed as having IBD. |
| doi_str_mv | 10.1097/MPG.0000000000000409 |
| format | Article |
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Background:
Inflammatory bowel disease–associated liver diseases (IBD‐LDs) include autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and an overlap syndrome. Prospective unbiased multicenter data regarding the frequency of IBD‐LD in patients with pediatric inflammatory bowel disease (IBD) are lacking. We examined early alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (GGT) elevations in children diagnosed as having IBD and assessed the likelihood of IBD‐LD.
Methods:
Data collected from the prospective observational Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry enrolling children of age <16 years within 30 days of diagnosis. AIH, PSC, and overlap syndrome were diagnosed using local institutional criteria.
Results:
A total of 1569 subjects had liver enzymes available. Of the total, 757 had both ALT and GGT, 800 had ALT only (no GGT), and 12 had GGT only (no ALT). Overall, 29 of 1569 patients (1.8%) had IBD‐LD. IBD‐LD was diagnosed in 1 of 661 (0.15%) of patients with both ALT and GGT ≤ 50 IU/L compared with 21 of 42 (50%) of patients with both ALT and GGT > 50 (odds ratio 660, P < 0.0001). Of the 29 patients with IBD‐LD, 21 had PSC, 2 had AIH, and 6 had overlap syndrome. IBD‐LD was more common in patients with ulcerative colitis and IBD‐unclassified (indeterminate colitis) than in those with Crohn disease (4% vs 0.8%, respectively, P < 0.001).
Conclusions:
Elevation of both ALT and GGT within 90 days after the diagnosis of IBD is associated with a markedly increased likelihood of IBD‐LD. Both ALT and GGT levels should be measured in all of the pediatric patients newly diagnosed as having IBD.</description><identifier>ISSN: 0277-2116</identifier><identifier>EISSN: 1536-4801</identifier><identifier>DOI: 10.1097/MPG.0000000000000409</identifier><identifier>PMID: 24796799</identifier><language>eng</language><publisher>United States: by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</publisher><subject>Adolescent ; Alanine Transaminase - blood ; Child ; Cholangitis, Sclerosing - blood ; Cholangitis, Sclerosing - enzymology ; Cholangitis, Sclerosing - epidemiology ; Colitis, Ulcerative - blood ; Colitis, Ulcerative - enzymology ; Crohn Disease - blood ; Crohn Disease - enzymology ; Female ; Follow-Up Studies ; gamma-Glutamyltransferase - blood ; Hepatitis, Autoimmune - blood ; Hepatitis, Autoimmune - enzymology ; Hepatitis, Autoimmune - epidemiology ; Humans ; inflammatory bowel disease ; liver enzyme ; Male ; Prospective Studies ; sclerosing cholangitis ; Time Factors</subject><ispartof>Journal of pediatric gastroenterology and nutrition, 2014-09, Vol.59 (3), p.321-323</ispartof><rights>2014 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition</rights><rights>2014 by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4569-78bab7e452ca227959624f13693fd9817a74d8af97e7349fc00b31c6562471333</citedby><cites>FETCH-LOGICAL-c4569-78bab7e452ca227959624f13693fd9817a74d8af97e7349fc00b31c6562471333</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1097%2FMPG.0000000000000409$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1097%2FMPG.0000000000000409$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,781,785,1418,27926,27927,45576,45577</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24796799$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Goyal, Alka</creatorcontrib><creatorcontrib>Hyams, Jeffery S.</creatorcontrib><creatorcontrib>Lerer, Trudy</creatorcontrib><creatorcontrib>Leleiko, Neal S.</creatorcontrib><creatorcontrib>Otley, Anthony R.</creatorcontrib><creatorcontrib>Griffiths, Anne M.</creatorcontrib><creatorcontrib>Rosh, Joel R.</creatorcontrib><creatorcontrib>Cabrera, Jose M.</creatorcontrib><creatorcontrib>Oliva‐Hemker, Maria M.</creatorcontrib><creatorcontrib>Mack, David R.</creatorcontrib><creatorcontrib>Rick, James N.</creatorcontrib><creatorcontrib>Pfefferkorn, Marian D.</creatorcontrib><creatorcontrib>Carvalho, Ryan</creatorcontrib><creatorcontrib>Grossman, Andrew B.</creatorcontrib><creatorcontrib>Hitch, Meredith C.</creatorcontrib><creatorcontrib>Sudel, Boris</creatorcontrib><creatorcontrib>Kappelman, Michael D.</creatorcontrib><creatorcontrib>Saeed, Shehzad A.</creatorcontrib><creatorcontrib>Faubion, William A.</creatorcontrib><creatorcontrib>Schaefer, Marc E.</creatorcontrib><creatorcontrib>Markowitz, James F.</creatorcontrib><creatorcontrib>Keljo, David J.</creatorcontrib><creatorcontrib>Pediatric Inflammatory Bowel Disease Collaborative Research Group</creatorcontrib><creatorcontrib>Pediatric Inflammatory Bowel Disease Collaborative Research Group</creatorcontrib><title>Liver Enzyme Elevations Within 3 Months of Diagnosis of Inflammatory Bowel Disease and Likelihood of Liver Disease</title><title>Journal of pediatric gastroenterology and nutrition</title><addtitle>J Pediatr Gastroenterol Nutr</addtitle><description>ABSTRACT
Background:
Inflammatory bowel disease–associated liver diseases (IBD‐LDs) include autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and an overlap syndrome. Prospective unbiased multicenter data regarding the frequency of IBD‐LD in patients with pediatric inflammatory bowel disease (IBD) are lacking. We examined early alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (GGT) elevations in children diagnosed as having IBD and assessed the likelihood of IBD‐LD.
Methods:
Data collected from the prospective observational Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry enrolling children of age <16 years within 30 days of diagnosis. AIH, PSC, and overlap syndrome were diagnosed using local institutional criteria.
Results:
A total of 1569 subjects had liver enzymes available. Of the total, 757 had both ALT and GGT, 800 had ALT only (no GGT), and 12 had GGT only (no ALT). Overall, 29 of 1569 patients (1.8%) had IBD‐LD. IBD‐LD was diagnosed in 1 of 661 (0.15%) of patients with both ALT and GGT ≤ 50 IU/L compared with 21 of 42 (50%) of patients with both ALT and GGT > 50 (odds ratio 660, P < 0.0001). Of the 29 patients with IBD‐LD, 21 had PSC, 2 had AIH, and 6 had overlap syndrome. IBD‐LD was more common in patients with ulcerative colitis and IBD‐unclassified (indeterminate colitis) than in those with Crohn disease (4% vs 0.8%, respectively, P < 0.001).
Conclusions:
Elevation of both ALT and GGT within 90 days after the diagnosis of IBD is associated with a markedly increased likelihood of IBD‐LD. Both ALT and GGT levels should be measured in all of the pediatric patients newly diagnosed as having IBD.</description><subject>Adolescent</subject><subject>Alanine Transaminase - blood</subject><subject>Child</subject><subject>Cholangitis, Sclerosing - blood</subject><subject>Cholangitis, Sclerosing - enzymology</subject><subject>Cholangitis, Sclerosing - epidemiology</subject><subject>Colitis, Ulcerative - blood</subject><subject>Colitis, Ulcerative - enzymology</subject><subject>Crohn Disease - blood</subject><subject>Crohn Disease - enzymology</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>gamma-Glutamyltransferase - blood</subject><subject>Hepatitis, Autoimmune - blood</subject><subject>Hepatitis, Autoimmune - enzymology</subject><subject>Hepatitis, Autoimmune - epidemiology</subject><subject>Humans</subject><subject>inflammatory bowel disease</subject><subject>liver enzyme</subject><subject>Male</subject><subject>Prospective Studies</subject><subject>sclerosing cholangitis</subject><subject>Time Factors</subject><issn>0277-2116</issn><issn>1536-4801</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkEFPGzEQhS0EatK0_6BCPnJZsNfe9frAAdKQgkKbQ6seLWd3tmvwroO9SZT-egwJqOoF5jIazffmjR5CXyg5pUSKs9v59JT8W5zIAzSkGcsTXhB6iIYkFSJJKc0H6GMId5ERPCMf0CDlQuZCyiHyM7MGjyfd320LeGJhrXvjuoB_m74xHWb41nV9E7Cr8Vej_3QumOfhuqutblvdO7_Fl24DNu4D6ABYdxWemXuwpnGueoJ3Jvv9J3RUaxvg876P0K-ryc_xt2T2Y3o9vpglJc9ymYhioRcCeJaWOk2FzGSe8pqyXLK6kgUVWvCq0LUUIBiXdUnIgtEyzyImKGNshE52d5fePawg9Ko1oQRrdQduFRTNsshSTtKI8h1aeheCh1otvWm13ypK1FPaKqat_k87yo73DqtFC9Wr6CXeCBQ7YONsDz7c29UGvGpA27556_b5XmosbN_1j7qZf2eXVySPzuwR5W-b2Q</recordid><startdate>201409</startdate><enddate>201409</enddate><creator>Goyal, Alka</creator><creator>Hyams, Jeffery S.</creator><creator>Lerer, Trudy</creator><creator>Leleiko, Neal S.</creator><creator>Otley, Anthony R.</creator><creator>Griffiths, Anne M.</creator><creator>Rosh, Joel R.</creator><creator>Cabrera, Jose M.</creator><creator>Oliva‐Hemker, Maria M.</creator><creator>Mack, David R.</creator><creator>Rick, James N.</creator><creator>Pfefferkorn, Marian D.</creator><creator>Carvalho, Ryan</creator><creator>Grossman, Andrew B.</creator><creator>Hitch, Meredith C.</creator><creator>Sudel, Boris</creator><creator>Kappelman, Michael D.</creator><creator>Saeed, Shehzad A.</creator><creator>Faubion, William A.</creator><creator>Schaefer, Marc E.</creator><creator>Markowitz, James F.</creator><creator>Keljo, David J.</creator><general>by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>201409</creationdate><title>Liver Enzyme Elevations Within 3 Months of Diagnosis of Inflammatory Bowel Disease and Likelihood of Liver Disease</title><author>Goyal, Alka ; Hyams, Jeffery S. ; Lerer, Trudy ; Leleiko, Neal S. ; Otley, Anthony R. ; Griffiths, Anne M. ; Rosh, Joel R. ; Cabrera, Jose M. ; Oliva‐Hemker, Maria M. ; Mack, David R. ; Rick, James N. ; Pfefferkorn, Marian D. ; Carvalho, Ryan ; Grossman, Andrew B. ; Hitch, Meredith C. ; Sudel, Boris ; Kappelman, Michael D. ; Saeed, Shehzad A. ; Faubion, William A. ; Schaefer, Marc E. ; Markowitz, James F. ; Keljo, David J.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4569-78bab7e452ca227959624f13693fd9817a74d8af97e7349fc00b31c6562471333</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Adolescent</topic><topic>Alanine Transaminase - blood</topic><topic>Child</topic><topic>Cholangitis, Sclerosing - blood</topic><topic>Cholangitis, Sclerosing - enzymology</topic><topic>Cholangitis, Sclerosing - epidemiology</topic><topic>Colitis, Ulcerative - blood</topic><topic>Colitis, Ulcerative - enzymology</topic><topic>Crohn Disease - blood</topic><topic>Crohn Disease - enzymology</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>gamma-Glutamyltransferase - blood</topic><topic>Hepatitis, Autoimmune - blood</topic><topic>Hepatitis, Autoimmune - enzymology</topic><topic>Hepatitis, Autoimmune - epidemiology</topic><topic>Humans</topic><topic>inflammatory bowel disease</topic><topic>liver enzyme</topic><topic>Male</topic><topic>Prospective Studies</topic><topic>sclerosing cholangitis</topic><topic>Time Factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Goyal, Alka</creatorcontrib><creatorcontrib>Hyams, Jeffery S.</creatorcontrib><creatorcontrib>Lerer, Trudy</creatorcontrib><creatorcontrib>Leleiko, Neal S.</creatorcontrib><creatorcontrib>Otley, Anthony R.</creatorcontrib><creatorcontrib>Griffiths, Anne M.</creatorcontrib><creatorcontrib>Rosh, Joel R.</creatorcontrib><creatorcontrib>Cabrera, Jose M.</creatorcontrib><creatorcontrib>Oliva‐Hemker, Maria M.</creatorcontrib><creatorcontrib>Mack, David R.</creatorcontrib><creatorcontrib>Rick, James N.</creatorcontrib><creatorcontrib>Pfefferkorn, Marian D.</creatorcontrib><creatorcontrib>Carvalho, Ryan</creatorcontrib><creatorcontrib>Grossman, Andrew B.</creatorcontrib><creatorcontrib>Hitch, Meredith C.</creatorcontrib><creatorcontrib>Sudel, Boris</creatorcontrib><creatorcontrib>Kappelman, Michael D.</creatorcontrib><creatorcontrib>Saeed, Shehzad A.</creatorcontrib><creatorcontrib>Faubion, William A.</creatorcontrib><creatorcontrib>Schaefer, Marc E.</creatorcontrib><creatorcontrib>Markowitz, James F.</creatorcontrib><creatorcontrib>Keljo, David J.</creatorcontrib><creatorcontrib>Pediatric Inflammatory Bowel Disease Collaborative Research Group</creatorcontrib><creatorcontrib>Pediatric Inflammatory Bowel Disease Collaborative Research Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Goyal, Alka</au><au>Hyams, Jeffery S.</au><au>Lerer, Trudy</au><au>Leleiko, Neal S.</au><au>Otley, Anthony R.</au><au>Griffiths, Anne M.</au><au>Rosh, Joel R.</au><au>Cabrera, Jose M.</au><au>Oliva‐Hemker, Maria M.</au><au>Mack, David R.</au><au>Rick, James N.</au><au>Pfefferkorn, Marian D.</au><au>Carvalho, Ryan</au><au>Grossman, Andrew B.</au><au>Hitch, Meredith C.</au><au>Sudel, Boris</au><au>Kappelman, Michael D.</au><au>Saeed, Shehzad A.</au><au>Faubion, William A.</au><au>Schaefer, Marc E.</au><au>Markowitz, James F.</au><au>Keljo, David J.</au><aucorp>Pediatric Inflammatory Bowel Disease Collaborative Research Group</aucorp><aucorp>Pediatric Inflammatory Bowel Disease Collaborative Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Liver Enzyme Elevations Within 3 Months of Diagnosis of Inflammatory Bowel Disease and Likelihood of Liver Disease</atitle><jtitle>Journal of pediatric gastroenterology and nutrition</jtitle><addtitle>J Pediatr Gastroenterol Nutr</addtitle><date>2014-09</date><risdate>2014</risdate><volume>59</volume><issue>3</issue><spage>321</spage><epage>323</epage><pages>321-323</pages><issn>0277-2116</issn><eissn>1536-4801</eissn><abstract>ABSTRACT
Background:
Inflammatory bowel disease–associated liver diseases (IBD‐LDs) include autoimmune hepatitis (AIH), primary sclerosing cholangitis (PSC), and an overlap syndrome. Prospective unbiased multicenter data regarding the frequency of IBD‐LD in patients with pediatric inflammatory bowel disease (IBD) are lacking. We examined early alanine aminotransferase (ALT) and γ‐glutamyl transpeptidase (GGT) elevations in children diagnosed as having IBD and assessed the likelihood of IBD‐LD.
Methods:
Data collected from the prospective observational Pediatric Inflammatory Bowel Disease Collaborative Research Group Registry enrolling children of age <16 years within 30 days of diagnosis. AIH, PSC, and overlap syndrome were diagnosed using local institutional criteria.
Results:
A total of 1569 subjects had liver enzymes available. Of the total, 757 had both ALT and GGT, 800 had ALT only (no GGT), and 12 had GGT only (no ALT). Overall, 29 of 1569 patients (1.8%) had IBD‐LD. IBD‐LD was diagnosed in 1 of 661 (0.15%) of patients with both ALT and GGT ≤ 50 IU/L compared with 21 of 42 (50%) of patients with both ALT and GGT > 50 (odds ratio 660, P < 0.0001). Of the 29 patients with IBD‐LD, 21 had PSC, 2 had AIH, and 6 had overlap syndrome. IBD‐LD was more common in patients with ulcerative colitis and IBD‐unclassified (indeterminate colitis) than in those with Crohn disease (4% vs 0.8%, respectively, P < 0.001).
Conclusions:
Elevation of both ALT and GGT within 90 days after the diagnosis of IBD is associated with a markedly increased likelihood of IBD‐LD. Both ALT and GGT levels should be measured in all of the pediatric patients newly diagnosed as having IBD.</abstract><cop>United States</cop><pub>by European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology</pub><pmid>24796799</pmid><doi>10.1097/MPG.0000000000000409</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Journal of pediatric gastroenterology and nutrition, 2014-09, Vol.59 (3), p.321-323 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library All Journals; Journals@Ovid Complete |
| subjects | Adolescent Alanine Transaminase - blood Child Cholangitis, Sclerosing - blood Cholangitis, Sclerosing - enzymology Cholangitis, Sclerosing - epidemiology Colitis, Ulcerative - blood Colitis, Ulcerative - enzymology Crohn Disease - blood Crohn Disease - enzymology Female Follow-Up Studies gamma-Glutamyltransferase - blood Hepatitis, Autoimmune - blood Hepatitis, Autoimmune - enzymology Hepatitis, Autoimmune - epidemiology Humans inflammatory bowel disease liver enzyme Male Prospective Studies sclerosing cholangitis Time Factors |
| title | Liver Enzyme Elevations Within 3 Months of Diagnosis of Inflammatory Bowel Disease and Likelihood of Liver Disease |
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