Progressive familial intrahepatic cholestasis in adulthood: 60 years’ follow-up

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00209775%3A_____%2F20%3AN0000006" target="_blank" >RIV/00209775:_____/20:N0000006 - isvavai.cz</a>

Výsledek na webu

<a href="https://www.cskb.cz/wp-content/uploads/2020/05/KBM_1_2020_Jirsa-11.pdf" target="_blank" >https://www.cskb.cz/wp-content/uploads/2020/05/KBM_1_2020_Jirsa-11.pdf</a>

DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Progressive familial intrahepatic cholestasis in adulthood: 60 years’ follow-up

Popis výsledku v původním jazyce

Objective: Identify molecular basis of cholestatic cirrhosis with hepatocellular carcinoma (HCC) in a 55-year-old woman Design: Case study. Settings: Center of Cardiovascular Surgery and Transplantation, Brno, Czech Republic. Material and Methods: A woman aged 60y had pruritus and icterus as an infant, with normal-range serum gamma-glutamyl transpeptidase activity, that were palliated effectively by biliary diversion and pharmacotherapy. Cirrhosis (diagnosed at age 20y) was complicated by portal hypertension with variceal bleeding (29y) and hypersplenism requiring splenectomy (34y). Jaundice recurred after a viral illness treated with acetaminophen, and worsened; serum alpha-fetoprotein was elevated, and magnetic resonance imaging found a 22mm left-lobe mass. At transplant hepatectomy (55y), HCC arisen in cirrhosis was confirmed. Immunostaining for bile salt export pump (BSEP), encoded by ABCB11, was conducted and ATP8B1, ABCB11 and TJP2 were analyzed in the patient and her first-degree relatives. Results: BSEP was unremarkably expressed in the explanted liver. Compound heterozygosity for 2 pathogenic point mutations in ABCB11, encoding bile salt export pump (BSEP), was identified (c.2495G>A [p.Arg.832His] and c.2629G>A [p.Gly877Arg]), without ATP8B1 lesions. Both mutations are reported in association with progressive familial intrahepatic cholestasis. Conclusion: HCC associated with PFIC due to ABCB11 mutations is recognized in children. To our knowledge, no report in an adult has yet appeared. Our patient had PFIC with functional but not absolute deficiency of BSEP. Unusually slow progression of her disease can be attributed to residual BSEP function, assisted by surgical and medical palliative interventions.

Název v anglickém jazyce

Progressive familial intrahepatic cholestasis in adulthood: 60 years’ follow-up

Popis výsledku anglicky

Objective: Identify molecular basis of cholestatic cirrhosis with hepatocellular carcinoma (HCC) in a 55-year-old woman Design: Case study. Settings: Center of Cardiovascular Surgery and Transplantation, Brno, Czech Republic. Material and Methods: A woman aged 60y had pruritus and icterus as an infant, with normal-range serum gamma-glutamyl transpeptidase activity, that were palliated effectively by biliary diversion and pharmacotherapy. Cirrhosis (diagnosed at age 20y) was complicated by portal hypertension with variceal bleeding (29y) and hypersplenism requiring splenectomy (34y). Jaundice recurred after a viral illness treated with acetaminophen, and worsened; serum alpha-fetoprotein was elevated, and magnetic resonance imaging found a 22mm left-lobe mass. At transplant hepatectomy (55y), HCC arisen in cirrhosis was confirmed. Immunostaining for bile salt export pump (BSEP), encoded by ABCB11, was conducted and ATP8B1, ABCB11 and TJP2 were analyzed in the patient and her first-degree relatives. Results: BSEP was unremarkably expressed in the explanted liver. Compound heterozygosity for 2 pathogenic point mutations in ABCB11, encoding bile salt export pump (BSEP), was identified (c.2495G>A [p.Arg.832His] and c.2629G>A [p.Gly877Arg]), without ATP8B1 lesions. Both mutations are reported in association with progressive familial intrahepatic cholestasis. Conclusion: HCC associated with PFIC due to ABCB11 mutations is recognized in children. To our knowledge, no report in an adult has yet appeared. Our patient had PFIC with functional but not absolute deficiency of BSEP. Unusually slow progression of her disease can be attributed to residual BSEP function, assisted by surgical and medical palliative interventions.

Druh

J_ost - Ostatní články v recenzovaných periodicích

CEP obor

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OECD FORD obor

30219 - Gastroenterology and hepatology

Projekt

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Návaznosti

V - Vyzkumna aktivita podporovana z jinych verejnych zdroju

Rok uplatnění

2020

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Klinická mikrobiologie a infekční lékařství

ISSN

1211-264X

e-ISSN

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Svazek periodika

49

Číslo periodika v rámci svazku

1

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

4

Strana od-do

11-14

Kód UT WoS článku

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EID výsledku v databázi Scopus

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