Cholestasis is a condition in which bile is not properly transported from the liver to the small intestine. Cholestasis can be caused by an array of childhood diseases, including the genetic diseases Alagille syndrome (ALGS), alpha-1 antitrypsin (a-1AT) deficiency, bile acid synthesis and metabolism defects, and progressive familial intrahepatic cholestasis (PFIC) or benign recurrent intrahepatic cholestasis(BRIC). This study will investigate the natural history and progression of the four previously mentioned cholestatic liver diseases to provide a better understanding of the causes and effects of the diseases.
Cholestasis is a rare condition that involves a reduction or obstruction of bile flow from the liver to the small intestine. When bile flow is hindered, a waste product pigment called bilirubin can escape into the bloodstream and build up to harmful levels. This may lead to the easily recognizable cholestatic symptoms of jaundice, itching, and impaired growth and eventually to more serious health problems. Four rare genetic liver disorders- ALGS, a-1AT, bile acid synthesis and metabolism defects, and PFIC-account for about 20% to 30% of all infant cases of cholestasis. These four disorders compose a group of related diseases that can cause significant growth problems during childhood, serious liver problems, the need for liver transplantation, and potentially death. More research on these rare liver diseases is necessary to develop a scientific basis for improvement in diagnostic techniques and treatments. Current diagnostic procedures are complex, and the development of simpler diagnostic tests would facilitate early diagnosis and treatment. This study will investigate the natural history and progression of the four previously mentioned cholestatic liver diseases to provide a better understanding of the causes and effects of the diseases. Participants who have been previously enrolled into this study will be followed for 20 years, until transplanted, or death. Study visits will involve review of clinical information, family history, and any clinically indicated treatments and their outcomes; a physical exam; laboratory tests; and radiologic and imaging evaluations.
Study Type
OBSERVATIONAL
Enrollment
1,675
Children's Hospital of Los Angeles
Los Angeles, California, United States
University of California at San Francisco (UCSF)
San Francisco, California, United States
Children's Hospital Colorado
Aurora, Colorado, United States
Children's Healthcare of Atlanta - Emory University
Atlanta, Georgia, United States
Ann & Robert H. Lurie Children's Hospital of Chicago
Chicago, Illinois, United States
Riley Hospital for Children
Indianapolis, Indiana, United States
Johns Hopkins University Hospital
Baltimore, Maryland, United States
St. Louis University - Cardinal Glennon Children's Medical Center
St Louis, Missouri, United States
Washington University School of Medicine/St. Louis Children's Hospital
St Louis, Missouri, United States
Mount Sinai School of Medicine
New York, New York, United States
...and 7 more locations
Demonstration of disease progression for each of the four cholestatic liver diseases of the study, including liver transplantation, death, growth failure, worsening liver function, and developmental complications of portal high blood pressure
Time frame: Measured at baseline and annually through year 10
Jaundice (total serum bilirubin of greater than 2.0 mg/dl)
Time frame: Measured at baseline and annually through year 10
Listing for liver transplantation
Time frame: Measured at baseline and annually through year 10
Calculated Pediatric End-Stage Liver Disease (PELD) score for participants less than 12 years of age or Model for End-Stage Liver Disease (MELD) score for participants 12 years of age or older
Time frame: Measured at baseline and annually through year 10
Health related quality of life
Time frame: Measured at baseline and annually through year 10
Growth (length and weight Z-score)
Time frame: Measured at baseline and annually through year 10
Bone mineral density (lumbar and spine total body)
Time frame: Measured at baseline in ALGS and PFIC/BRIC subjects
Presence of hearing loss (ALGS and PFIC)
Time frame: Measured at baseline
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