Update on the diagnosis and management of neonatal intrahepatic cholestasis caused by citrin deficiency: Expert review on behalf of the Asian Pan-Pacific Society for Pediatric Gastroenterology, Hepatology, and Nutrition.
J Pediatr Gastroenterol Nutr
; 78(2): 178-187, 2024 Feb.
Article
em En
| MEDLINE
| ID: mdl-38374571
ABSTRACT
Citrin deficiency is an autosomal recessive metabolic liver disease caused by mutations in the SLC25A13 gene. The disease typically presents with cholestasis, elevated liver enzymes, hyperammonemia, hypercitrullinemia, and fatty liver in young infants, resulting in a phenotype known as "neonatal intrahepatic cholestasis caused by citrin deficiency" (NICCD). The diagnosis relies on clinical manifestation, biochemical evidence of hypercitrullinemia, and identifying mutations in the SLC25A13 gene. Several common mutations have been found in patients of East Asian background. The mainstay treatment is nutritional therapy in early infancy utilizing a lactose-free and medium-chain triglyceride formula. This approach leads to the majority of patients recovering liver function by 1 year of age. Some patients may remain asymptomatic or undiagnosed, but a small proportion of cases can progress to cirrhosis and liver failure, necessitating liver transplantation. Recently, advancements in newborn screening methods have improved the age of diagnosis. Early diagnosis and timely management improve patient outcomes. Further studies are needed to elucidate the long-term follow-up of NICCD patients into adolescence and adulthood.
Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Colestase
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Colestase Intra-Hepática
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Citrulinemia
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Transportadores de Ânions Orgânicos
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Gastroenterologia
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Doenças do Recém-Nascido
Limite:
Adolescent
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Child
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Humans
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Infant
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Newborn
Idioma:
En
Revista:
J Pediatr Gastroenterol Nutr
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Japão