Investigative MR Cholangiopancreatography for Primary Sclerosing Cholangitistype Lesions in Children With IBD

Alexopoulou, Efthymia*; Xenophontos, Polis E.*; Economopoulos, Nikos*; Spyridopoulos, Themistoklis N.*; Papakonstantinou, Olympia*; Panayotou, Ioanna; Dimakou, Konstantina; Roma, Eleftheria; Kelekis, Nikolaos L.*

Journal of Pediatric Gastroenterology & Nutrition: September 2012 - Volume 55 - Issue 3 - p 308–313
doi: 10.1097/MPG.0b013e31825bb3dc
Hepatology and Nutrition

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.

*Second Department of Radiology, National and Kapodistrian University of Athens, General University Hospital “Attikon,”

Gastroenterology Unit of the First Department of Pediatrics, National and Kapodistrian University of Athens, Aghia Sofia Children's Hospital, Athens, Greece.

Address correspondence and reprint requests to Nikolaos L. Kelekis MD, Professor of Radiology, Second Department of Radiology, General University Hospital “Attikon,” Rimini 1 St, Athens 12462, Greece (e-mail: kelnik@med.uoa.gr).

Received 5 June, 2011

Accepted 20 February, 2012

The authors report no conflicts of interest.

Copyright 2012 by ESPGHAN and NASPGHAN