Syndrome d'Alagille

Alagille syndrome is an inherited disorder that can affect multiple organ systems in the body. It may affect liver function as it causes fewer bile ducts leading to a build up of bile in the liver.

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what is alagille syndrome?

Alagille syndrome is an inherited disorder often seen in infants and young children that mimics other forms of prolonged liver disease. It occurs when an individual is born with fewer bile ducts than normal, leading to a build up of bile in the liver resulting in liver scarring and damage.

what is bile?

Bile is a thick yellow fluid made by the liver and stored in the gallbladder used to help break down food and remove waste. It is responsible for breaking down fats and fat-soluble vitamins (A, D, E, K) so they can be absorbed through the digestive system.

en bref

  • Alagille syndrome is present in 1 in every 30, 000 live births.
  • There is a 50% chance of a child developing Alagille syndrome if 1 parent has Alagille syndrome.

symptômes

Symptoms of Alagille syndrome in the first three months of life include:

  • poor growth
  • jaundice
  • pale and loose stools

Symptoms of Alagille syndrome later in childhood:

  • slow growth and difficultly gaining weight
  • jaundice
  • serve itchy skin (known as pruritus)

Frequently the disease stabilizes between ages four and ten with an improvement in symptoms.

l'impact du mode de vie

Majority of people with Alagille syndrome can live a normal life, while others may experience organ failure if left untreated.

que puis-je faire ?

la prévention

Alagille syndrome is a disease caused by genetics, so it cannot be prevented.

diagnostic

Diagnosis can be established by microscopic examination of liver biopsy specimens, a stethoscope examination of the child’s heart and chest, a special eye examination (slit-lamp exam), an x-ray of the spinal column and an ultrasound examination of the abdomen. Genetic testing can also be performed to confirm unusual or mild cases.

traitement

Treatment of Alagille syndrome is primarily medical and not surgical and is based on trying to increase the flow of bile from the liver, maintain normal growth and development, and prevent or correct any of the specific nutritional deficiencies that often develop.

  • Medications are often prescribed to increase bile flow to improve digestion of fats and fat-soluble vitamins.
  • Medications such as ursodeoxycholic acid and cholestyramine can help relieve itches caused by the buildup of bile in the blood and skin.
  • Increasing the amount of medium-chain triglycerides (MCTs) to formula for infants is often recommended as this can form of fat can be well digested for individuals with Alagille syndrome and provides essential nutrients.
  • Increasing the amount of fat-soluble vitamins (A, D, E, K) since problems with fat digestion and absorption can lead to deficiencies in these essential vitamins.  Deficiencies of these vitamins can be diagnosed by blood tests and usually can be corrected by vitamin supplements.
  • There is presently no procedure that can correct the loss of the bile ducts within the liver. In 20 to 30 per cent of patients, liver cirrhosis advances to a stage where the liver fails to perform its functions.  Liver transplantation is then considered.

The overall life expectancy for children with Alagille syndrome is unknown, but depends on several factors: the severity of scarring in the liver and/or the need for liver transplantation, the risk of stroke and whether heart or lung problems develop because of the narrowing in the pulmonary artery.

ressources supplémentaires

Voici quelques questions à poser à votre médecin ou à l'équipe médicale :

  • What is my family’s risk of developing Alagille syndrome? Should my family be tested?
  • What treatment and/or lifestyle modifications are beneficial for someone with Alagille syndrome?
  • How severe is my liver damage?