JLE

Hépato-Gastro & Oncologie Digestive

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Screening of biliary and liver diseases in inflammatory bowel disease. Consequences on the therapeutic management Volume 19, issue 4, Avril 2012

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Authors
Centre hospitalier Lyon-Sud, service d’hépato-gastroentérologie, 69495 Pierre-Bénite ; Inserm U851, Faculté de Médecine Lyon-Sud Charles Mérieux, Oullins, France

The discovery of liver biological abnormalities at the time of diagnosis or throughout the follow-up of an inflammatory bowel disease (IBD) is a frequent event. These liver and biliary disorders are often latent and associated with, at least at the beginning, no clinical evidence. Their screenings are based on the practice of laboratory liver function tests and the identification of their aetiologies is crucial because some of these disorders are potentially severe in the medium to long term. Conversely, to impute wrongly a drug in the hepatic disturbances leads mostly to his unsuitable exclusion for the patient. The primary sclerosing cholangitis remains rare during IBD (around 5 %) but justifies a specific management and monitoring. Next to the biliary lesions, parenchymatous or vascular hepatic lesions are possible as steatosis, amylosis, granulomatosis, iatrogenic or auto-immune hepatitis. Liver disturbances were reported with the majority of drugs commonly used in IBD and especially with thiopurines.