Samantha A Woodruff1, Marci K Sontag2, Frank J Accurso3, Ronald J Sokol1, Michael R Narkewicz4. 1. Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition and Digestive Health Institute, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States. 2. Department of Epidemiology, Colorado School of Public Health, University of Colorado School of Medicine and Children's Hospital Colorado Aurora, CO, United States. 3. Section of Pediatric Pulmonology, Colorado School of Public Health, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States. 4. Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology and Nutrition and Digestive Health Institute, University of Colorado School of Medicine and Children's Hospital Colorado, Aurora, CO, United States. Electronic address: narkewicz@childrenscolorado.org.
Abstract
BACKGROUND: Prevalence and risks for elevated liver enzymes have not been studied systematically in children with CF identified by newborn screen. METHODS: 298 CF children identified by newborn screen since 1982. AST, ALT and GGT tested at annual visits. Percent of children with 1 or ≥2 values of elevated AST, ALT and GGT determined. Relationship of liver enzymes to clinical factors or subsequent liver disease was analyzed RESULTS: At least one abnormal value for AST (63%), ALT (93%) and ALT ≥1.5× ULN (52%) occurred by 21years of age. Liver enzyme elevations were not correlated with CFTR mutation, meconium ileus or ethnicity. AST and GGT ≥1.5× ULN were associated with later advanced liver disease HR (CI) 6.53 (2.02-21.1) and 4.03 (1.15-13.45), respectively. CONCLUSIONS: Elevated liver enzymes are common during childhood in CF patients identified by newborn screen. Elevated AST and GGT may be markers for risk of advanced liver disease.
BACKGROUND: Prevalence and risks for elevated liver enzymes have not been studied systematically in children with CF identified by newborn screen. METHODS: 298 CF children identified by newborn screen since 1982. AST, ALT and GGT tested at annual visits. Percent of children with 1 or ≥2 values of elevated AST, ALT and GGT determined. Relationship of liver enzymes to clinical factors or subsequent liver disease was analyzed RESULTS: At least one abnormal value for AST (63%), ALT (93%) and ALT ≥1.5× ULN (52%) occurred by 21years of age. Liver enzyme elevations were not correlated with CFTR mutation, meconium ileus or ethnicity. AST and GGT ≥1.5× ULN were associated with later advanced liver disease HR (CI) 6.53 (2.02-21.1) and 4.03 (1.15-13.45), respectively. CONCLUSIONS: Elevated liver enzymes are common during childhood in CF patients identified by newborn screen. Elevated AST and GGT may be markers for risk of advanced liver disease.
Authors: Simon C Ling; Wen Ye; Daniel H Leung; Oscar M Navarro; Alexander Weymann; Wikrom Karnsakul; A Jay Freeman; John C Magee; Michael R Narkewicz Journal: J Pediatr Gastroenterol Nutr Date: 2019-09 Impact factor: 2.839
Authors: Marilyn J Siegel; A Jay Freeman; Wen Ye; Joseph J Palermo; Jean P Molleston; Shruti M Paranjape; Janis Stoll; Daniel H Leung; Prakash Masand; Boaz Karmazyn; Roger Harned; Simon C Ling; Oscar M Navarro; Wikrom Karnsakul; Adina Alazraki; Sarah Jane Schwarzenberg; Frank Glen Seidel; Alex Towbin; Estella M Alonso; Jennifer L Nicholas; Karen F Murray; Randolph K Otto; Averell H Sherker; John C Magee; Michael R Narkewicz Journal: J Pediatr Date: 2020-02-12 Impact factor: 4.406