염증성 장질환 환자의 간담도계 발현
Hepatobiliary Manifestation of Inflammatory Bowel Disease
서광일, 강상범,
소속 상세정보
서광일 ( Seo Kwang-Il )
고신대학교 의과대학 내과학교실
강상범 ( Kang Sang-Bum )
가톨릭대학교 의과대학 대전성모병원 소화기내과
Abstract
The hepatobiliary system is one of the most common sites of extraintestinal manifestation in patients with inflammatory bowel disease (IBD). The progression of IBD can lead to a primary hepatobiliary manifestation and can occur secondary to multiple drugs or accompanying viral infections. Primary sclerosing cholangitis is the representative hepatobiliary manifestation of IBD, particularly in ulcerative colitis. Although most agents used in the treatment of IBD are potentially hepatotoxic, the risk of serious hepatitis or liver failure is low. The prevalence of HBV and HCV in IBD is similar to the general population, but the clinical concern is HBV reactivation associated with immunosuppressive therapy. Patients undergoing cytotoxic chemotherapy or immunosuppressive therapy with a moderate to high risk of HBV reactivation require prophylactic antiviral therapy. On the other hand, HCV has little risk of reactivation. Patients with IBD are more likely to have nonalcoholic fatty liver disease than the general population and tend to occur at younger ages. IBD and cholelithiasis are closely related, especially in Crohn's disease.
키워드
Inflammatory bowel diseases; Primary sclerosing cholangitis; Drug induced liver injury; Hepatitis viruses; Cholelithiasis
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