title: Prevalence of low phospholipid-associated cholelithiasis in young female patients.
abstract: OBJECTIVE
  We evaluated the prevalence of low phospholipid-associated cholelithiasis, a specific form of cholelithiasis associated with at least 2 of the 3 following criteria: first symptoms before the age of 40; intrahepatic comet tail artefacts, sludge or microlithiasis on ultrasound imaging; and recurrence of symptoms after cholecystectomy.
  
  
  METHODS
  We prospectively studied the cases of 60 consecutive female patients under 30 with symptomatic cholelithiasis.
  
  
  RESULTS
  A diagnosis of low phospholipid-associated cholelithiasis was made in 14/60 patients (23%). The molecular analysis showed ABCB4 (n=4) and ABCB11 (n=4) gene mutations. Low phospholipid-associated cholelithiasis was frequently observed in non-overweight patients [13/27 (48%)], was present in most patients whose biliary symptoms occurred before the age of 18 [7/10 (70%)] and was often associated with cholangitis or acute pancreatitis [9/14 (64%), p<0.05] while "common" cholelithiasis was mainly associated with cholecystitis [16/46 (35%), p<0.05].
  
  
  CONCLUSIONS
  Nearly one quarter of the female patients under the age of 30 admitted for symptomatic cholelithiasis had low phospholipid-associated cholelithiasis; particularly if body weight was normal, the symptoms began before the age of 18 or in the presence of severe biliary complications.
authors.affiliation: Services d'hépato-gastro-entérologie, de radiologie et de chirurgie viscérale, Hôpital Saint-Camille, Bry-sur-Marne, France. Electronic address: B.Condat@ch-bry.org.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Condat
authors.forename: David
authors.initials: D
authors.lastname: Zanditenas
authors.forename: Véronique
authors.initials: V
authors.lastname: Barbu
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Hauuy
authors.forename: Béatrice
authors.initials: B
authors.lastname: Parfait
authors.forename: Ahmed
authors.initials: A
authors.lastname: El Naggar
authors.forename: Véronique
authors.initials: V
authors.lastname: Collot
authors.forename: Joélle
authors.initials: J
authors.lastname: Bonnet
authors.forename: Yann
authors.initials: Y
authors.lastname: Ngo
authors.forename: Anware
authors.initials: A
authors.lastname: Maftouh
authors.forename: Laurent
authors.initials: L
authors.lastname: Dugué
authors.forename: Chant
authors.initials: C
authors.lastname: Balian
authors.forename: Alain
authors.initials: A
authors.lastname: Charlier
authors.forename: Martine
authors.initials: M
authors.lastname: Blazquez
authors.forename: Olivier
authors.initials: O
authors.lastname: Rosmorduc
mesh_terms: D018435:ATP Binding Cassette Transporter, Subfamily B / Q000235:genetics / Q000378:metabolism; D000074020:ATP Binding Cassette Transporter, Subfamily B, Member 11; D018528:ATP-Binding Cassette Transporters / Q000235:genetics / Q000378:metabolism; D000293:Adolescent; D000328:Adult; D002769:Cholelithiasis / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism; D004247:DNA / Q000235:genetics; D004252:DNA Mutational Analysis; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006801:Humans; D010743:Phospholipids / Q000378:metabolism*; D017354:Point Mutation; D015995:Prevalence; D011446:Prospective Studies; D055815:Young Adult
chemical_list: C093491:ABCB11 protein, human; D018435:ATP Binding Cassette Transporter, Subfamily B; D000074020:ATP Binding Cassette Transporter, Subfamily B, Member 11; D018528:ATP-Binding Cassette Transporters; D010743:Phospholipids; D004247:DNA; C095122:multidrug resistance protein 3
keywords: ABCB11 gene; ABCB4 gene; LPAC; PFIC; Protein MDR3; UDCA; Ursodeoxycholic acid therapy; low phospholipid associated cholelithiasis; progressive familial intrahepatic cholestasis; ursodeoxycholic acid therapy