Losurdo Giuseppe, Brescia Irene Vita, Lillo Chiara, Mezzapesa Martino, Barone Michele, Principi Mariabeatrice, Ierardi Enzo, Di Leo Alfredo, Rendina Maria
Section of Gastroenterology, Department of Emergency and Organ Transplantation, University of Bari, Bari 70124, Italy.
World J Hepatol. 2021 Nov 27;13(11):1534-1551. doi: 10.4254/wjh.v13.i11.1534.
Inflammatory bowel disease (IBD) may show a wide range of extraintestinal manifestations. In this context, liver involvement is a focal point for both an adequate management of the disease and its prognosis, due to possible serious comorbidity. The association between IBD and primary sclerosing cholangitis is the most known example. This association is relevant because it implies an increased risk of both colorectal cancer and cholangiocarcinoma. Additionally, drugs such as thiopurines or biologic agents can cause drug-induced liver damage; therefore, this event should be considered when planning IBD treatment. Additionally, particular consideration should be given to the evidence that IBD patients may have concomitant chronic viral hepatitis, such as hepatitis B and hepatitis C. Chronic immunosuppressive regimens may cause a hepatitis flare or reactivation of a healthy carrier state, therefore careful monitoring of these patients is necessary. Finally, the spread of obesity has involved even IBD patients, thus increasing the risk of non-alcoholic fatty liver disease, which has already proven to be more common in IBD patients than in the non-IBD population. This phenomenon is considered an emerging issue, as it will become the leading cause of liver cirrhosis.
炎症性肠病（IBD）可能会表现出广泛的肠外表现。在这种情况下，由于可能存在严重的合并症，肝脏受累对于疾病的充分管理及其预后而言都是一个重点。IBD与原发性硬化性胆管炎之间的关联是最广为人知的例子。这种关联很重要，因为它意味着结直肠癌和胆管癌的风险都会增加。此外，硫唑嘌呤或生物制剂等药物可导致药物性肝损伤；因此，在规划IBD治疗时应考虑到这一情况。此外，应特别关注IBD患者可能同时患有慢性病毒性肝炎，如乙型肝炎和丙型肝炎这一证据。慢性免疫抑制方案可能会导致肝炎发作或健康携带者状态的重新激活，因此对这些患者进行仔细监测是必要的。最后，肥胖的蔓延甚至涉及到了IBD患者，从而增加了非酒精性脂肪性肝病的风险，事实证明这种疾病在IBD患者中比在非IBD人群中更为常见。这一现象被认为是一个新出现的问题，因为它将成为肝硬化的主要原因。
