Department of Life Sciences, Universidade do Estado da Bahia, Rua Silveira Martins 2555, Cabula 41150-000, Salvador, Bahia, Brazil.
Hospital Geral Roberto Santos (HGRS), Rua Direta do Saboeiro s/n, Cabula - CEP: 41180-780, Salvador, Bahia, Brazil.
Biomed Res Int. 2019 Jan 31;2019:7604939. doi: 10.1155/2019/7604939. eCollection 2019.
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.
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.
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.
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.
在炎症性肠病（IBD）患者中，有报道称会出现肝胆系统表现，因此本研究旨在评估炎症性肠病参考中心中克罗恩病（CD）和溃疡性结肠炎（UC）患者的肝胆系统表现。
这是一项炎症性肠病参考中心的横断面研究，于 2015 年 7 月至 2016 年 8 月进行访谈和病历回顾。使用了一份包含流行病学和临床特征的调查问卷。
我们共访谈了 306 例患者，其中大多数为 UC（53.9%）和女性（61.8%）。IBD 患者中有 60 例（19.6%）存在肝胆系统表现。在大多数患者（56.7%）中，在诊断 IBD 后发现肝胆系统疾病。在 UC 患者（18.2%）中，发现的肝胆系统疾病有 11 例（6.7%）非酒精性脂肪肝，9 例（5.5%）胆石症，6 例（3.6%）原发性硬化性胆管炎（PSC），3 例（1.8%）与硫唑嘌呤相关的肝毒性，1 例（0.6%）乙型肝炎，1 例（0.6%）肝纤维化。在 CD 患者（21.3%）中，有 11 例（7.8%）胆石症，11 例（7.8%）非酒精性脂肪肝，4 例（2.8%）PSC，3 例（2.1%）肝毒性，1 例（0.7%）乙型肝炎，1 例（0.7%）丙型肝炎，1 例（0.7%）酒精性肝病，1 例（0.7%）自身免疫性肝炎（AIH）。有 1 例 PSC/AIH 重叠综合征。
在评估的患者中，两种 IBD 形式的肝胆系统疾病发生率相似。IBD 患者最常见的非特异性肝胆系统表现是非酒精性肝病和胆石症。在广泛 UC 或回肠结肠 CD 受累的患者中，最常见的特异性肝胆系统疾病是 PSC，这种疾病多见于男性患者。
