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Prognosis, with evaluation of general biochemistry, of liver disease in lymphoedema cholestasis syndrome 1 (LCS1/Aagenaes syndrome) 

Authors: Monica Drivdal a;  Torleif Trydal b;  Tor-Arne Hagve c;  Ingunn Bergstad d; Oslashystein Aagenaeligs e
Affiliations:   a Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
b Department of Clinical Chemistry, Sorlandet Hospital, Kristiansand, Norway
c Department of Clinical Chemistry, The National Hospital, Oslo, Norway
d Department of Nutrition and Dietetics, Aker University Hospital, Oslo, Norway
e Children's Centre, Ulleval University Hospital, Oslo, Norway
DOI: 10.1080/00365520500335183
Publication Frequency: 12 issues per year
Published in: journal Scandinavian Journal of Gastroenterology, Volume 41, Issue 4 March 2006 , pages 465 - 471
Formats available: HTML (English) : PDF (English)
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Abstract

Objective. To investigate the prognosis of liver disease in Aagenaes syndrome (lymphoedema cholestasis syndrome 1 (LCS1)), which is an autosomal recessive inherited syndrome consisting of neonatal cholestasis with intermittent cholestatic episodes in childhood into adulthood and development of lymphoedema. Forty Norwegian patients are known to have this condition, 25 of whom are alive. A clinical description of the liver disease is supplied with a case-control study. Material and methods. In this paper we review the course of the liver disease in the Norwegian cohort of patients and present results from a case-control study in the patients above 10 years of age. The case-control study was performed on 15 patients without clinical cholestasis (itching and sometimes jaundice) at the time of the study. An evaluation of 11 patients above 15 years of age without chronic biochemical cholestasis (increased alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT) and/or serum bile acids) was also carried out. For each patient one randomly identified control person was included (15 in one study, 11 in the other). Results. Cirrhosis with either transplantation or death in infancy or early childhood occurred in six patients; slowly developing cirrhosis occurred in three patients. Two patients may be in the process of developing cirrhosis. Significantly increased ALP and GGT levels were found in patients with normal liver biochemistry in the preceding years when compared with the case control group. Additionally, albumin was found to be lower in older patients. Conclusions. Compared with that for other types of hereditary neonatal cholestasis, patients with LCS1 have a relatively good prognosis. More than 50% can expect a normal life span.
Keywords: Aagenaes syndrome; biochemical investigation; cholestasis; lymphoedema cholestasis syndrome 1; LCS1; prognosis
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