Abnormal Liver Blood Tests in Inflammatory Bowel Disease
A.Tony, O.Casey, G.Cullen.
Centre for Colorectal Disease, St.Vincent’s University Hospital
Abnormal liver blood tests in inflammatory bowel disease (IBD) patients are common and may reflect significant co-existing pathology.
To examine the prevalence of abnormal liver blood tests (LFT) in a cohort of IBD patients and assess the extent to which these abnormalities are investigated.
The LFTs of IBD patients attending the IBD clinic in SVUH between June 2020 and December 2020 were recorded. The data were obtained from the hospital laboratory system and the SVUH IBD database. Abnormal LFTs were defined as an elevation in any liver blood test greater than two times the upper limit of normal. The records of patients with abnormal LFTs were checked for evidence of further investigation of possible underlying liver disease.
Of the 805 patients attending the clinic in the study period, 131 patients had abnormal LFTs (16.3%). 81 were male. The mean duration of IBD was 14.1 years. Elevated ALT was the most common abnormality [42/131(32%)]. 73% (95/131) had a “liver screen” blood series performed and 49% (64/131) had a liver ultrasound. At the time of data collection, 40% (51/131) of patients’ LFTs had normalised. Twelve patients (9%) were diagnosed with primary sclerosing cholangitis.
Three quarters of IBD patients with abnormal liver blood tests in our clinic underwent further investigation with a liver screen and half had basic liver imaging. Improved awareness of the need to check and act on LFT results in the IBD clinic may improve investigation of liver abnormalities and detect potentially significant liver disease.