Academic Journal

Diagnostic workup of suspected hereditary cholestasis in adults: a case report

التفاصيل البيبلوغرافية
العنوان: Diagnostic workup of suspected hereditary cholestasis in adults: a case report
المؤلفون: Carola Dröge, Tobias Götze, Annika Behrendt, Holger Gohlke, Verena Keitel
المصدر: Exploration of Digestive Diseases, Vol 2, Iss 2, Pp 34-43 (2023)
بيانات النشر: Open Exploration Publishing Inc., 2023.
سنة النشر: 2023
المجموعة: LCC:Diseases of the digestive system. Gastroenterology
مصطلحات موضوعية: hereditary cholestasis, low phospholipid-associated cholelithiasis (lpac), genetic analysis, farnesoid x receptor (fxr), multidrug resistance protein 3 (mdr3), registry, Diseases of the digestive system. Gastroenterology, RC799-869
الوصف: Hereditary cholestasis comprises a broad spectrum of clinical phenotypes of varying severity. Severe forms such as progressive familial intrahepatic cholestasis (PFIC) mostly affect children with disease onset within their first years. Nevertheless, late-onset PFIC forms are increasingly diagnosed. Most adults present with less severe forms of hereditary cholestasis, often suffering from pruritus, gallstone disease, jaundice, or elevated liver enzymes. To identify the underlying genetic background and to rule out potential differential diagnoses, a broad genetic analysis like whole exome sequencing (WES) is recommended. Knowledge of the affected gene may have an impact not only on patient surveillance due to risk for disease progression or tumor development but also on potential therapeutic strategies. This case of the adult patient illustrates the importance of broad genetic analysis, which brought up the potentially relevant rare multidrug resistance protein 3 (MDR3) missense variant p.(Asn489Tyr) underlying the patient’s clinical phenotype of low phospholipid-associated cholelithiasis (LPAC). Patients with MDR3 disease may have an increased risk for cholangiocarcinoma (CCA) development and therefore need an individualized surveillance strategy. Most MDR3-affected patients benefit from life-long therapy with ursodeoxycholic acid (UDCA), which is well tolerated. Bezafibrate treatment can reduce pruritus, one of the main symptoms affecting the quality of life. Whether the administration of ileal bile acid transporter (IBAT) inhibitors is beneficial in adult patients with MDR3 disease is so far unknown.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 2833-6321
Relation: https://www.explorationpub.com/Journals/edd/Article/100516; https://doaj.org/toc/2833-6321
DOI: 10.37349/edd.2023.00016
URL الوصول: https://doaj.org/article/efb2b2f47c55463c8153afc6c666d7d9
رقم الانضمام: edsdoj.fb2b2f47c55463c8153afc6c666d7d9
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:28336321
DOI:10.37349/edd.2023.00016