Prevalence and prognostic value of hepatic histological alterations in patients with Crohn's disease. (December 2015)

• Record Type: Journal Article
• Authors: Ribaldone, Davide Giuseppe; Garavagno, Marco; Pellicano, Rinaldo; Bresso, Francesca; Fagoonee, Sharmila; David, Ezio; Sapone, Nicoletta; Bonagura, Antonio Gabriele; Resegotti, Andrea; Astegiano, Marco
• Is Part Of: Scandinavian journal of gastroenterology. Volume 50:Number 12(2015)
• Page Start: 1463
• Page End: 1468
• Publication Date: 2015-12
• Subjects: Gastroenterology -- Periodicals; Digestive organs -- Diseases -- Periodicals; 616.33
• Languages: English
• ISSNs: 0036-5521

Abstract

<abstract> <title>Abstract</title> <p>Variable degrees of liver histological changes in patients with Crohn's disease (CD) have been reported. <bold><italic>Objective.</italic></bold> To evaluate the liver histological alterations and their prognostic significance in patients affected by CD without abnormalities of liver biochemical parameters and ultrasound features. <bold><italic>Material and Methods.</italic></bold> A prospective, single-blind study, including 35 consecutive patients with CD that underwent bowel resection with a contemporary performance of liver biopsy from 1992 to 2003. Exclusion criteria: the presence of standard causes of liver disease, such as alcohol consumption exceeding 20 g/day, primary sclerosing cholangitis, viral infections, celiac disease, metabolic syndrome and alterations of the metabolism. Patients were followed up with regular evaluation of hepatic cytolysis, cholestasis, synthesis and ultrasound performance. After a mean interval of 14 years (from May to December 2013), liver fibrosis was assessed by Fibroscan®. <bold><italic>Results.</italic></bold> Histological alterations were shown in 60% of patients, without serious liver injuries (no case of inflammation or significant fibrosis). Fibroscan® was performed in 33 subjects and no significant changes were observed (mean value of liver stiffness: 5.2 ± 1.2 kPa). The minimal microscopic damage did not evolve either in patients with a normal histology or in those with an altered histology at baseline (<italic>p</italic> = 0.9). Only patients who took azathioprine had a statistically significant increase of liver stiffness values (5.7 ± 1.5 kPa vs 4.7 ± 1.3 kPa, <italic>p</italic> = 0.017). <bold><italic>Conclusions.</italic></bold> Patients with CD do not need additional examinations compared to the general population, unless clinical or biochemical abnormalities are found.</p> </abstract>