title: The natural history of Shwachman-Diamond syndrome-associated liver disease from childhood to adulthood.
abstract: OBJECTIVE
  In order to characterize the natural course of Shwachman-Diamond syndrome (SDS)-associated hepatopathy we evaluated liver biochemistry and imaging findings, and their evolution with age, in patients with SDS and verified SBDS mutations.
  
  
  METHODS
  Retrospective and cross-sectional liver imaging, biochemical and histologic data of 12 patients (age range 2.1 to 37 years) with SBDS mutations were analyzed. Hepatic volume and parenchymal structure were determined from magnetic resonance imaging data.
  
  
  RESULTS
  Hepatomegaly and aminotransaminase elevation was observed in most of the patients with SDS at an early age; values normalized by age 5 years and remained normal over extended follow-up. Mild to moderate serum bile acid elevation was noted in 7 patients (58%). On magnetic resonance imaging, no patients (n = 11) had evidence of hepatic steatosis, cirrhosis, or fibrosis. Three middle-aged patients had hepatic microcysts.
  
  
  CONCLUSIONS
  SDS-associated hepatopathy has overall good prognosis. No major hepatic abnormalities developed during extended follow-up to adulthood. Mild cholestasis in follow-up even after normalization of transaminase levels may reflect primary alterations in liver metabolism in SDS.
authors.affiliation: Helsinki Medical Imaging Center, Helsinki University Central Hospital, Helsinki, Finland. sanna.toiviainen-salo@fimnet.fi
authors.forename: Sanna
authors.initials: S
authors.lastname: Toiviainen-Salo
authors.forename: Peter R
authors.initials: PR
authors.lastname: Durie
authors.forename: Kirsti
authors.initials: K
authors.lastname: Numminen
authors.forename: Päivi
authors.initials: P
authors.lastname: Heikkilä
authors.forename: Eino
authors.initials: E
authors.lastname: Marttinen
authors.forename: Erkki
authors.initials: E
authors.lastname: Savilahti
authors.forename: Outi
authors.initials: O
authors.lastname: Mäkitie
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008107:Liver Diseases / Q000201:enzymology / Q000209:etiology* / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009154:Mutation / Q000235:genetics*; D011506:Proteins / Q000235:genetics*; D012189:Retrospective Studies; D013577:Syndrome; D000637:Transaminases / Q000378:metabolism; D055815:Young Adult
chemical_list: D011506:Proteins; C470521:SBDS protein, human; D000637:Transaminases