Article Text

LIVER FUNCTION AND BILE DUCT DISORDERS IN THE COURSE OF INFLAMMATORY BOWEL DISEASES
  1. U Grzybowska-Chlebowczyk1,
  2. S Wiecek1,
  3. H Wos1,
  4. M Kajor2,
  5. M Szymanska1
  1. 1Department of Paediatrics, Silesian Medical University, Katowice, Poland
  2. 2Department of Pathomorphology, Silesian Medical University, Katowice, Poland

Abstract

The aim of the study was the evaluation of the incidence of chronic liver and bile duct diseases, the analysis of biochemical parameters of liver function and their relation to the clinical course of inflammatory bowel disease (IBD) in children.

Materials and Methods The study comprised 92 children, aged 3–18 years with IBD. In all the patients the following examinations were performed: biochemical tests evaluating liver and bile duct function, immunological examinations—levels of IgA, M, G, autoantibodies (ANCA, ASCA, ANA, AMA, ASMA and LKM) and ultrasound examination of the abdomen.

Results The mean values of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, bilirubin and gammaglutamyltranspeptidase were higher in the patients with ulcerative colitis than in the children with Crohn’s disease. Increased levels of alanine aminotransferase were observed in 11/48 children with ulcerative colitis (23%) and in 6/44 children with Crohn’s disease (13.6%). Elevated values of gammaglutamyltranspeptidase were found in 5/48 (10.48%) children with ulcerative colitis. In all these children the further diagnostics (histopathological examination of liver bioptates and cholangio-MR) revealed primary sclerosing cholangitis. A coexistence of autoimmune hepatitis was diagnosed in one boy with ulcerative colitis.

Conclusions 1. The control of liver function parameters and cholestatasis is necessary in all children with IBD. In children with ulcerative colitis increased parameters of liver cell damage were observed much more frequently in comparison with the patients with Crohn’s disease. 2. It seems that the presence of ANCA antibodies may indicate a potential, future development of PSC in patients with diagnosed ulcerative colitis.

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