Open AccessSCLEROSING CHOLANGITIS IN CHILDREN AND ADOLESCENTS: CURRENT STATE OF THE PROBLEM
Author(s) -
Г. В. Волынец,
А.И. Хавкин,
Т. А. Скворцова,
В. В. Маткаш,
А. В. Никитин
Publication year - 2019
Publication title -
rossijskij pediatričeskij žurnal
Language(s) - English
Resource type - Journals
eISSN - 2413-2918
pISSN - 1560-9561
DOI - 10.18821/1560-9561-2018-21-5-312-318
Subject(s) - medicine , azathioprine , prednisone , primary sclerosing cholangitis , calprotectin , gastroenterology , liver transplantation , etiology , inflammatory bowel disease , colonoscopy , ulcerative colitis , disease , transplantation , colorectal cancer , cancer
There are presented generalized data on modern methods of diagnosis and treatment of sclerosing cholangitis (SCh), a chronic inflammatory liver disease of unknown etiology affecting the intrahepatic and/or extrahepatic bile ducts resulting in cirrhosis of the liver. In children, 2 forms of SCh are distinguished: primary (PSCh) and autoimmune (ASCh). Diagnosis of SCh requires performing cholangiography. ACh responds to standard immunosuppressive treatment with prednisone/prednisone and azathioprine. Supportive immunosuppressive therapy should last at least 2-3 years. After the end of such treatment, the doctor should continue to monitor changes in the ratios of AST/ALT/IgG autoantibodies in the blood of patients every 3-month for at least 5 years. SCh is often associated with inflammatory bowel disease, which should be excluded in the debut by determining the content of fecal calprotectin and colonoscopy data. In children, liver transplantation is one of the options for the treatment of Ch. However, the frequency of relapses after transplantation remains high, especially in ACh patients.