P049 Investigation of Liver Diseases by Ultrasound in Patients With Inflammatory Bowel Disease

Abstract

BACKGROUND: Inflammatory Bowel Disease (IBD), which can be divided into Crohn’s Disease (CD) and Ulcerative Colitis (UC), is an immune mediated disease featured by gastrointestinal tract involvement. Hepatic disease, such as non-alcoholic fatty liver disease (NAFLD), cirrhosis, cholelithiasis, hepatic thromboembolic events and primary sclerosing cholangitis (PSC) are some hepatic complications presented by IBD patients. Since these hepatic disorders have a higher prevalence in IBD patients, ultrasonography is a noninvasive low-cost versatile tool, that allows to identify these manifestations at early stages. Therefore, this study aims to analyze the prevalence of hepatic diseases in patients with IBD. METHODS: A cross-sectional study was performed in a single IBD center, Brazil. This study considered clinical and sociodemographic data of these individuals, besides the evaluation of disease activity, biochemical tests, and liver ultrasound with doppler. Statistical analysis: descriptive, association tests. RESULTS: 71 patients were included, 34 had CD and 37 had UC, mean age 45.32 ± 13.59 years, 63.38% women. Among CD patients, 42.42% have ileocolonic involvement, 50% penetrating behavior and 39.4% perianal involvement. Among patients with UC, most patients have pancolitis (72.22%). Most patients were in clinical (CD: 93.55%, UC: 63.89%) and endoscopic (47.14%) remission. The main medications used were azathioprine (46.48%), infliximab (40.85%), salicylates (28.17%), corticosteroids (16.9%) and adalimumab (11.27%). According to ultrasound, NAFLD was found in 32 (45.07%) patients: 40.63% mild, 40.63% moderate and 18.75% severe. Furthermore, we found a correlation between liver steatosis and blunt liver edge (p < 0.0155). Only 2 patients presented with choledocholithiasis. One patient had features of chronic liver disease such as irregular surface, heterogeneity of a hepatic parenchymal echo and bluntness of the liver edge. No signs of thrombosis were found in portal, splenic or superior mesenteric veins. CONCLUSION: A higher prevalence of NAFLD was found in patients with IBD, and no signs of thrombosis were found in the splanchnic system.

Ultrasound Prevalence and Clinical Features of Nonalcoholic Fatty Liver Disease in Patients with Inflammatory Bowel Diseases: A Real-Life Cross-Sectional Study

“…In this context, our study showed a US prevalence of NAFLD of 23% in IBD patients. These data are in line with recent epidemiological investigations that showed a US prevalence of 20-50% [12,29,30,34]. Given that IBD is a risk factor for NAFLD, this result underlines the importance of performing hepatic US in at-risk patients.…”

“…Another study showed the US prevalence of NAFLD in IBD patients treated with biological therapy at 54% [29]. Similar results were obtained by Shintaku et al, with a US prevalence of NAFLD of 45% among 71 enrolled IBD patients [30]. In addition, due to the newly proposed nomenclature of metabolic-associated fatty liver disease (MAFLD), there is a need for continuous evaluation of the clinical features of these patients, especially from a metabolic perspective [7].…”