14800-DvRappard

149 Gallbladder and the risk of polyps and carcinoma in metachromatic leukodystrophy 9 Cholecystectomy was performed if polyps exceeded 5mm in patients having undergone HSCT or before planned HSCT. In the case of cholecystectomy, a pathologist experienced in neurometabolic disorders reviewed macroscopic and microscopic findings. In addition to routine hematoxylin and eosin stain, additional histochemical and immunohistochemical stains were used to identify macrophages containing sulfatides (metachromasia with toluidine blue), confirm intestinal metaplasia (Periodic acid-Schiff), and detect expression of the tumor suppressor gene product p53 (1:500, Dako). We reviewed the radiologic and pathologic results, collected between 2009 and 2015, in our cohort. Symptoms possibly related to gallbladder abnormalities, such as biliary colic, vomiting, nausea, jaundice, anorexia and abdominal pain in the right upper quadrant were screened for during the regular visits and information was collected from patient charts. Standard protocol approvals, registration and patient consents : the study received approval of the medical ethics review board of our hospital. RESULTS Clinical characteristics and findings at ultrasound We included 34 patients in our study. Table 2 shows the demographic characteristics of our cohort. Thirteen patients of our cohort had received allogeneic HSCT for treatment of MLD. Eight patients (24%) had symptoms possibly related to gallbladder abnormalities such as episodes of biliary colic, nonspecific abdominal pain or frequent vomiting. Intestinal bleeding, as previously described due to papillomatosis, 9 was not encountered. Unequivocal diagnosis of biliary colic was difficult in some cases with advanced neurologic disease. Management was usually conservative, vomiting was treated with antiemetic drugs, resulting in some relief. One patient with gallstones was treated during 6months with ursodeoxycholic acid, without effect on cholecystolithiasis or on frequent vomiting. Another had recurrent pancreatitis in the absence of gallstones on ultrasound after a HSCT procedure. Findings at gallbladder ultrasoundare shown infigure1and table1. Anormal gallbladder was found in only 8of 34 (24%) patients. Eight (62%) of HSCT-treated patients had an abnormal gallbladder at ultrasound, showing possible polyps in 6 of them.