Prospective noninvasive analysis of hepatic fibrosis in patients with Crohn’s disease: correlation of transient elastography and laboratory-based markers - Introduction

A Special Author Introduction
European Journal of Gastroenterology & Hepatology
ISSN: 0954-691X • Frequency: 12/year • Subscribe Now

By Dr Ulrich Böcker

Crohn's disease is characterized by chronic relapsing or progressive immune-mediated inflammation of the gastrointestinal tract. In 20-40% of the cases inflammatory bowel disease is associated with extraintestinal manifestations. As opposed to affected joints, eyes and skin, involvement of the hepatobiliary tract may be clinically less obvious, although potentially threatening to the patient. Further, the etiopathogenesis of liver damage remains often difficult to establish due to possible drug-related toxicity. The disease burden in Crohn's disease patients is high, due to the inflammatory activity and subsequent symptoms, diagnostic procedures and treatment-associated side-effects. Liver-related procedures could cause additional stress and harm for the patient. However, recently non-invasive tests such as laboratory based scoring systems for the assessment of liver fibrosis have been developed and validated in viral hepatitis. Moreover, elastography has been introduced to assess liver stiffness, and it has helped to avoid liver biopsy. A combination of elastography and biomarkers may facilitate clinical decision making. Until now it is unclear whether this approach may be reasonably applied to patient populations with a low probability of liver damage where the risk-benefit ratio of invasive procedures would certainly be higher than in classical liver patients. Therefore, studies analyzing the potential of non-invasive markers of liver injury are mandatory. In the current center-based, unselected cohort of patients with Crohn's disease, the positive correlations between laboratory-based markers of fibrosis and transient elastography were in fact highly significant.  

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