Frequency of Hepatobiliary Manifestations and Concomitant Liver Disease in Inflammatory Bowel Disease Patients

Biomed Res Int. 2019 Jan 31:2019:7604939. doi: 10.1155/2019/7604939. eCollection 2019.

Abstract

Background: In inflammatory bowel disease (IBD) patients there are reports of the occurrence of hepatobiliary manifestations, so the aim of this study was to evaluate the hepatobiliary manifestations in patients with Crohn's disease (CD) and ulcerative colitis (UC) from an IBD reference center.

Methods: Cross-sectional study in an IBD reference center, with interviews and review of medical charts, between July 2015 and August 2016. A questionnaire addressing epidemiological and clinical characteristics was used.

Results: We interviewed 306 patients, and the majority had UC (53.9%) and were female (61.8%). Hepatobiliary manifestations were observed in 60 (19.6%) patients with IBD. In the greater part of the patients (56.7%) hepatobiliary disorders were detected after the diagnosis of IBD. In UC (18.2%) patients, the hepatobiliary disorders identified were 11 (6.7%) non-alcoholic fatty liver disease, 9 (5.5%) cholelithiasis, 6 (3.6%) primary sclerosing cholangitis (PSC), 3 (1.8%) hepatotoxicity associated with azathioprine, 1 (0.6%) hepatitis B, and 1 (0.6%) hepatic fibrosis. In CD (21.3%) patients, 11 (7.8%) had cholelithiasis, 11 (7.8%) non-alcoholic fatty liver disease, 4 (2.8%) PSC, 3 (2.1%) hepatotoxicity, 1 (0.7%) hepatitis B, (0.7%) hepatitis C, 1 (0.7%) alcoholic liver disease, and 1 (0.7%) autoimmune hepatitis (AIH). There was one case of PSC/AIH overlap syndrome.

Conclusion: The frequency of hepatobiliary disorders was similar in both forms of IBD in patients evaluated. The most common nonspecific hepatobiliary manifestations in IBD patients were non-alcoholic liver disease and cholelithiasis. The most common specific hepatobiliary disorder was PSC in patients with extensive UC or ileocolonic CD involvement; this was seen more frequently in male patients.

MeSH terms

  • Adult
  • Azathioprine / adverse effects
  • Cholelithiasis / diagnosis
  • Cholelithiasis / physiopathology
  • Colitis, Ulcerative / diagnosis
  • Colitis, Ulcerative / physiopathology
  • Crohn Disease / diagnosis
  • Crohn Disease / physiopathology
  • Cross-Sectional Studies
  • Female
  • Hepatitis B / diagnosis
  • Hepatitis B / physiopathology
  • Hepatitis C / diagnosis
  • Hepatitis C / physiopathology
  • Hepatitis, Autoimmune / diagnosis
  • Hepatitis, Autoimmune / physiopathology
  • Hepatobiliary Elimination*
  • Humans
  • Inflammatory Bowel Diseases / classification
  • Inflammatory Bowel Diseases / diagnosis*
  • Inflammatory Bowel Diseases / physiopathology
  • Liver / physiopathology*
  • Liver Diseases / classification
  • Liver Diseases / pathology
  • Liver Diseases, Alcoholic / diagnosis
  • Liver Diseases, Alcoholic / physiopathology
  • Male
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / diagnosis
  • Non-alcoholic Fatty Liver Disease / physiopathology
  • Young Adult

Substances

  • Azathioprine