Hepatobiliary manifestations in patients with inflammatory bowel disease (Doctoral thesis)

Φουσέκης, Φωτίος

Background: Hepatobiliary and pancreatic manifestations have been reported in patients with Crohn’s disease or ulcerative colitis. Our aim was to describe the prevalence of hepatobiliary and pancreatic manifestations in inflammatory bowel disease and their association with the disease itself and the medications used. Methods: Data were retrospectively extracted from the clinical records of patients followed up at our tertiary IBD referral Center. Results: Our study included 602 IBD patients, with liver function tests at regular intervals. The mean follow-up was 5.8 years (Std. Dev.: 6.72). Abdominal imaging examinations were present in 220 patients and revealed findings from the liver, biliary tract and pancreas in 54.5% of examined patients (120 patients). The most frequent findings or manifestations from the liver, biliary tract and pancreas were fatty liver, cholelithiasis and acute pancreatitis, respectively. There were 7 patients with primary sclerosing cholangitis. Regarding hepatitis viruses, one-third of the patients had been tested for hepatitis B and C. 5.3% of them had positive hepatitis B surface antigen and 13.4% had past infection with hepatitis B virus (positive anti-HBcore). In addition, most of the patients were not immune against hepatitis B (negative anti-HBs), while 3% of patients were anti-HCV positive and only one patient had active hepatitis C. Furthermore, 28 patients had drug-related side effects from the liver and pancreas. The side effects included 23 cases of hepatotoxicity, 3 cases of acute pancreatitis. Moreover, there were two cases of HBV reactivation and one case of exacerbation of HCV infection, which were successfully treated. Conclusion: In our study, approximately one out of four patients had some kind of hepatobiliary or pancreatic manifestation. Therefore, it is essential to monitor liver function at regular intervals and differential diagnosis should range from innocent diseases and various drug related side effects to severe disorders, such as primary sclerosing cholangitis.
Institution and School/Department of submitter: Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής
Subject classification: Φλεγμονώδεις νόσοι του εντέρου
Keywords: Ιδιοπαθή φλεγμονώδη πάθηση των εντέρων,Ήπαρ,Χοληφόροι οδοί,Ηπατοτοξικότητα,Inflammatory bowel diseases,Liver,Biliary tract,Hepatotoxicity
URI: http://olympias.lib.uoi.gr/jspui/handle/123456789/29469
Appears in Collections:Διδακτορικές Διατριβές

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