Alagille Syndrome and Its Clinical and Laboratory Features: A Case Report

Livers Pub Date : 2022-10-09 DOI:10.3390/livers2040021
L. Abenavoli, L. Boccuto, A. Corea, M. Gambardella, R. Spagnuolo, F. Luzza
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Abstract

Alagille syndrome (ALGS) is a genetic-driven condition of chronic cholestasis, involving the intrahepatic bile ducts, heart, vessels, kidneys, skeletal tissues, eyes, and nervous system. Pathological mechanisms are still not defined. JAG1 and NOTCH2 gene mutations are responsible for most cases (96–97%). Diagnosis is based on clinical and laboratory findings—especially the presence of chronic cholestasis—and on genetic assessment. Bone abnormalities, deficiency of liposoluble vitamins, heart issues, and pruritus are the most prominent features of ALGS. Diagnostic imaging, such as ultrasonography, magnetic resonance imaging, and bone mass density assessment, is useful to study hepatic disease progression, estimate the risk of bone fracture, and rule out malignities. Therapy is based on ursodeoxycholic acid, rifampicin, cholestyramine, and supplementation of liposoluble vitamins. New therapeutic approaches are under investigation. Here, we describe a case of an individual with ALGS presenting with congenital chronic cholestasis and a long clinical history, in which pruritus is the main symptom.
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Alagille综合征及其临床和实验室特征1例报告
Alagille综合征(ALGS)是一种遗传性慢性胆汁淤积症,累及肝内胆管、心脏、血管、肾脏、骨骼组织、眼睛和神经系统。病理机制仍未明确。JAG1和NOTCH2基因突变是大多数病例(96-97%)的原因。诊断是基于临床和实验室结果-特别是慢性胆汁淤积的存在-和遗传评估。骨骼异常、脂溶性维生素缺乏、心脏问题和瘙痒是ALGS最突出的特征。诊断成像,如超声、磁共振成像和骨密度评估,有助于研究肝脏疾病的进展,估计骨折的风险,并排除恶性肿瘤。治疗以熊去氧胆酸、利福平、胆胺和补充脂溶性维生素为基础。新的治疗方法正在研究中。在这里,我们描述一个个案与ALGS的个人表现为先天性慢性胆汁淤积和长期的临床病史,其中瘙痒是主要症状。
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