title: Prevalence and prognostic value of hepatic histological alterations in patients with Crohn's disease.
abstract: Variable degrees of liver histological changes in patients with Crohn's disease (CD) have been reported.
  
  
  OBJECTIVE
  To evaluate the liver histological alterations and their prognostic significance in patients affected by CD without abnormalities of liver biochemical parameters and ultrasound features.
  
  
  METHODS
  A prospective, single-blind study, including 35 consecutive patients with CD that underwent bowel resection with a contemporary performance of liver biopsy from 1992 to 2003.
  
  
  METHODS
  the presence of standard causes of liver disease, such as alcohol consumption exceeding 20 g/day, primary sclerosing cholangitis, viral infections, celiac disease, metabolic syndrome and alterations of the metabolism. Patients were followed up with regular evaluation of hepatic cytolysis, cholestasis, synthesis and ultrasound performance. After a mean interval of 14 years (from May to December 2013), liver fibrosis was assessed by Fibroscan®.
  
  
  RESULTS
  Histological alterations were shown in 60% of patients, without serious liver injuries (no case of inflammation or significant fibrosis). Fibroscan® was performed in 33 subjects and no significant changes were observed (mean value of liver stiffness: 5.2 ± 1.2 kPa). The minimal microscopic damage did not evolve either in patients with a normal histology or in those with an altered histology at baseline (p = 0.9). Only patients who took azathioprine had a statistically significant increase of liver stiffness values (5.7 ± 1.5 kPa vs 4.7 ± 1.3 kPa, p = 0.017).
  
  
  CONCLUSIONS
  Patients with CD do not need additional examinations compared to the general population, unless clinical or biochemical abnormalities are found.
authors.affiliation: Department of Gastroenterology and Hepatology, Città della Salute e della Scienza-Molinette Hospital , Turin , Italy.
authors.forename: Davide Giuseppe
authors.initials: DG
authors.lastname: Ribaldone
authors.forename: Marco
authors.initials: M
authors.lastname: Garavagno
authors.forename: Rinaldo
authors.initials: R
authors.lastname: Pellicano
authors.forename: Francesca
authors.initials: F
authors.lastname: Bresso
authors.forename: Sharmila
authors.initials: S
authors.lastname: Fagoonee
authors.forename: Ezio
authors.initials: E
authors.lastname: David
authors.forename: Nicoletta
authors.initials: N
authors.lastname: Sapone
authors.forename: Antonio Gabriele
authors.initials: AG
authors.lastname: Bonagura
authors.forename: Andrea
authors.initials: A
authors.lastname: Resegotti
authors.forename: Marco
authors.initials: M
authors.lastname: Astegiano
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001379:Azathioprine / Q000627:therapeutic use*; D001706:Biopsy; D003424:Crohn Disease / Q000150:complications* / Q000188:drug therapy / Q000601:surgery; D054459:Elasticity Imaging Techniques; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D016037:Single-Blind Method; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents; D001379:Azathioprine
keywords: Crohn’s disease; bowel resection; liver biopsy; liver disease; liver elastography