Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review

Abstract Introduction Progressive Familial intrahepatic cholestasis (PFIC) are rare disorders of bile acid (BAs) secretion and transport with a genetic background. PFIC are paediatric manifestations, but the same variants causing PFIC can also cause cholestasis with a later paediatric onset or adult...

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Main Authors: Giovanni Vitale, Marco Sciveres, Claudia Mandato, Adamo Pio d’Adamo, Angelo Di Giorgio
Format: Article
Language:English
Published: BMC 2025-02-01
Series:Orphanet Journal of Rare Diseases
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Online Access:https://doi.org/10.1186/s13023-025-03599-2
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author Giovanni Vitale
Marco Sciveres
Claudia Mandato
Adamo Pio d’Adamo
Angelo Di Giorgio
author_facet Giovanni Vitale
Marco Sciveres
Claudia Mandato
Adamo Pio d’Adamo
Angelo Di Giorgio
author_sort Giovanni Vitale
collection DOAJ
description Abstract Introduction Progressive Familial intrahepatic cholestasis (PFIC) are rare disorders of bile acid (BAs) secretion and transport with a genetic background. PFIC are paediatric manifestations, but the same variants causing PFIC can also cause cholestasis with a later paediatric onset or adult-onset cholestatic disease (AOCD). Pruritus is a symptom of cholestasis that can be so devastating that it requires a liver transplant (LT) in children; some PFIC types have been described as at risk of liver cancer development. Commonly prescribed medications for PFIC symptoms can partially relieve pruritus without changing the natural history of the disease. Recently, a therapy reducing the intestinal resorption of BAs has been approved; it is effective on both pruritus and cholestasis in PFIC, potentially being a disease-modifying intervention. Areas covered The clinical and genetic characteristics of different PFIC and AOCD are summarized to provide a common background for geneticists and paediatric and adult hepatologists in diagnosis and management. Expert opinion Collaboration between paediatric and adult hepatologists and geneticists will become crucial for cholestatic disease research and patient treatment. Therefore, adult hepatologists will need to learn more about FIC. This might enable the implementation of individualized surveillance in FIC patients and the evaluation of patient family histories.
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spelling doaj-art-a6dd4a0ff1944a598b648eed5a657d9a2025-08-20T03:10:51ZengBMCOrphanet Journal of Rare Diseases1750-11722025-02-0120112110.1186/s13023-025-03599-2Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art reviewGiovanni Vitale0Marco Sciveres1Claudia Mandato2Adamo Pio d’Adamo3Angelo Di Giorgio4Internal Medicine Unit for the Treatment of Severe Organ Failure, IRCCS Azienda Ospedaliero-Universitaria di BolognaEpatologia e Clinica dei Trapianti, Ospedale Pediatrico IRCCS Bambino GesùDipartimento di Medicina, Chirurgia e Odontoiatria “Scuola Medica Salernitana”, Section of PediatricsDepartment of Medicine, Surgery and Health Sciences, University of TriestePediatric Hepatology Gastroenterology and Transplantation, Hospital Papa Giovanni XIIIAbstract Introduction Progressive Familial intrahepatic cholestasis (PFIC) are rare disorders of bile acid (BAs) secretion and transport with a genetic background. PFIC are paediatric manifestations, but the same variants causing PFIC can also cause cholestasis with a later paediatric onset or adult-onset cholestatic disease (AOCD). Pruritus is a symptom of cholestasis that can be so devastating that it requires a liver transplant (LT) in children; some PFIC types have been described as at risk of liver cancer development. Commonly prescribed medications for PFIC symptoms can partially relieve pruritus without changing the natural history of the disease. Recently, a therapy reducing the intestinal resorption of BAs has been approved; it is effective on both pruritus and cholestasis in PFIC, potentially being a disease-modifying intervention. Areas covered The clinical and genetic characteristics of different PFIC and AOCD are summarized to provide a common background for geneticists and paediatric and adult hepatologists in diagnosis and management. Expert opinion Collaboration between paediatric and adult hepatologists and geneticists will become crucial for cholestatic disease research and patient treatment. Therefore, adult hepatologists will need to learn more about FIC. This might enable the implementation of individualized surveillance in FIC patients and the evaluation of patient family histories.https://doi.org/10.1186/s13023-025-03599-2AdultBile acidsCholestasisIntrahepaticDrug therapyPaediatric
spellingShingle Giovanni Vitale
Marco Sciveres
Claudia Mandato
Adamo Pio d’Adamo
Angelo Di Giorgio
Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
Orphanet Journal of Rare Diseases
Adult
Bile acids
Cholestasis
Intrahepatic
Drug therapy
Paediatric
title Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
title_full Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
title_fullStr Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
title_full_unstemmed Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
title_short Genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis: a state-of-the-art review
title_sort genotypes and different clinical variants between children and adults in progressive familial intrahepatic cholestasis a state of the art review
topic Adult
Bile acids
Cholestasis
Intrahepatic
Drug therapy
Paediatric
url https://doi.org/10.1186/s13023-025-03599-2
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