Journal List > Korean J Gastroenterol > v.73(5) > 1125194

Seo and Kang: Hepatobiliary Manifestation of Inflammatory Bowel Disease

Abstract

The hepatobiliary system is one of the most common sites of extraintestinal manifestation in patients with inflammatory bowel disease (IBD). The progression of IBD can lead to a primary hepatobiliary manifestation and can occur secondary to multiple drugs or accompanying viral infections. Primary sclerosing cholangitis is the representative hepatobiliary manifestation of IBD, particularly in ulcerative colitis. Although most agents used in the treatment of IBD are potentially hepatotoxic, the risk of serious hepatitis or liver failure is low. The prevalence of HBV and HCV in IBD is similar to the general population, but the clinical concern is HBV reactivation associated with immunosuppressive therapy. Patients undergoing cytotoxic chemotherapy or immunosuppressive therapy with a moderate to high risk of HBV reactivation require prophylactic antiviral therapy. On the other hand, HCV has little risk of reactivation. Patients with IBD are more likely to have nonalcoholic fatty liver disease than the general population and tend to occur at younger ages. IBD and cholelithiasis are closely related, especially in Crohn's disease.

Figures and Tables

Table 1

Hepatobiliary Manifestation in Patients with Inflammatory Bowel Disease

kjg-73-248-i001

CD, Crohn's disease; UC, ulcerative colitis.

Table 2

Risk of HBV Reactivation according to the Types and Dose of Medication

kjg-73-248-i002

HBV, hepatitis B virus; TNF-α, tumor necrosis factor-alpha.

Notes

Financial support None.

Conflict of interest None.

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Sang-Bum Kang
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