Correlation of Inflammatory Bowel Diseases with Liver Involvement Severity in Autoimmune Hepatobiliary Pathology: Cross-Sectional Study

Abstract

Background. Inflammatory bowel diseases (IBD) often occur with hepatobiliary system involvement, including autoimmune ones. The role of IBD in development and severity of liver fibrosis in children remains unknown.Objective. The aim of the study is to study the correlation of IBD with the presence and severity of liver fibrotic changes and its malfunction at hepatobiliary system autoimmune disorders in children.Methods. The study included patients hospitalized with isolated (control group) autoimmune hepatobiliary disorders (HBD) (autoimmune hepatitis, primary sclerosing cholangitis, overlap syndrome, autoimmune cholangitis, primary biliary cholangitis) or in combination with IBD. The presence and severity of liver fibrosis was evaluated via invasive (estimation of inflammation activity and liver fibrosis via the METAVIR scale, areas of collagen IV deposition in liver biopsy slides) and non-invasive methods (transient liver elastography, collagen IV levels, liver enzymes activity).Results. Patients with autoimmune hepatobiliary disorders associated with IBD (n = 41) were comparable to those in control group (n = 44) by gender and age. Patients with IBD were more likely to be diagnosed with autoimmune hepatitis and primary sclerosing cholangitis. Furthermore, patients with IBD had higher frequency of moderate fibrosis, higher gamma glutamine transferase activity, and lower albumin concentration in comparison with patients of control group. We haven't revealed any other differences between both groups on other indicators.Conclusion. IBD are associated with relatively high incidence and severity of liver fibrotic changes in autoimmune HBD compared to isolated autoimmune HBD cases. However, these differences may be due to the differences in autoimmune HBD structure and, subsequently, its treatment.

Keywords

• children
• liver fibrosis
• liver cirrhosis
• inflammatory bowel disease
• autoimmune hepatitis
• primary sclerosing cholangitis