title: Liver Function Test Abnormalities in Patients with Inflammatory Bowel Diseases: A Hospital-based Survey.
abstract: OBJECTIVE
  Inflammatory bowel diseases (IBD) are frequently associated with altered liver function tests (LFTs). The causal relationship between abnormal LFTs and IBD is unclear. The aim of our study was to evaluate the prevalence and etiology of LFTs abnormalities and their association with clinical variables in a cohort of IBD patients followed up in a single center.
  
  
  METHODS
  A retrospective review was undertaken of all consecutive IBD in- and outpatients routinely followed up at a single referral center. Clinical and demographic parameters were recorded. Subjects were excluded if they had a previous diagnosis of chronic liver disease. LFT abnormality was defined as an increase in aspartate aminotransferase, (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), or total bilirubin.
  
  
  RESULTS
  A cohort of 335 patients (179 males, mean age 46.0 ± 15.6 years) was analyzed. Abnormal LFTs were detected in 70 patients (20.9%). In most cases, the alterations were mild and spontaneously returned to normal values in about 60% of patients. Patients with abnormal LFTs were less frequently on treatment with aminosalicylates (22.8 vs. 36.6%, P = 0.04). The most frequent cause for transient abnormal LFTs was drug-induced cholestasis (34.1%), whereas fatty liver was the most frequent cause of persistent liver damage (65.4%). A cholestatic pattern was found in 60.0% of patients and was mainly related to older age, longer duration of disease, and hypertension.
  
  
  CONCLUSIONS
  The prevalence of LFT abnormalities is relatively high in IBD patients, but the development of severe liver injury is exceptional. Moreover, most alterations of LFTs are mild and spontaneously return to normal values. Drug-induced hepatotoxicity and fatty liver are the most relevant causes of abnormal LFTs in patients with IBD.
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Maria
authors: M
authors: Cappello
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Claudia
authors: C
authors: Randazzo
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Ivana
authors: I
authors: Bravatà
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Anna
authors: A
authors: Licata
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Sergio
authors: S
authors: Peralta
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Antonio
authors: A
authors: Craxì
authors: Gastroenterology and Hepatology Section, Dipartimento Biomedico di Medicina Interna e Specialistica, Università di Palermo, Palermo, Italy.
authors: Piero Luigi
authors: PL
authors: Almasio
keywords: drug-induced hepatotoxicity; fatty liver; inflammatory bowel disease; liver function tests