Hepatobiliary associations with inflammatory bowel disease

Expert Rev Gastroenterol Hepatol. 2009 Dec;3(6):681-91. doi: 10.1586/egh.09.53.

Abstract

Hepatobiliary disease is not uncommon in patients with inflammatory bowel disease (IBD). The most common autoimmune hepatic associations are primary sclerosing cholangitis (PSC) and autoimmune hepatitis (AIH). The immunosuppressant medications used in the treatment of IBD also have potential hepatotoxicity. PSC is most commonly associated with IBD, specifically ulcerative colitis. AIH, a more classic autoimmune disease diagnosed commonly in isolation of other conditions in the same individual, is less commonly associated with IBD. Additionally, a subgroup of patients have features of both PSC and AIH, termed overlap syndrome, that is also sometimes seen in IBD patients. This review will discuss the most common liver disease associations seen in patients with IBD: PSC, AIH and overlap syndrome. Additionally, the most common drug-related hepatotoxicities encountered when treating IBD will be reviewed.

Publication types

  • Review

MeSH terms

  • Cholangitis, Sclerosing / drug therapy
  • Cholangitis, Sclerosing / epidemiology
  • Cholangitis, Sclerosing / physiopathology*
  • Hepatitis, Autoimmune / drug therapy
  • Hepatitis, Autoimmune / epidemiology
  • Hepatitis, Autoimmune / physiopathology*
  • Humans
  • Immunosuppressive Agents / adverse effects
  • Immunosuppressive Agents / therapeutic use
  • Incidence
  • Inflammatory Bowel Diseases / drug therapy
  • Inflammatory Bowel Diseases / epidemiology
  • Inflammatory Bowel Diseases / physiopathology*
  • Steroids / therapeutic use
  • Ursodeoxycholic Acid / therapeutic use

Substances

  • Immunosuppressive Agents
  • Steroids
  • Ursodeoxycholic Acid