The data obtained in long-term study allowed the following conclusions: – PSC can develop at any stage of the course of IBD, but the majority of patients it occurs within 5 years of onset (80.6% in the NUC, 76.5% in CD) – Lost liver during the first year of onset is more common in CD than in NUC (29.4% in CD, 19.4% at NUC) – The total defeat of the colon in patients with PSC is observed at NUC in 86% of cases, in BC 100% – The course of PSC is independent on the activity of inflammation in the gut. In 10-25% of cases the disease is asymptomatic. Despite the satisfactory state of patients for many years, the disease can progress with the development of cirrhosis liver, and the reason for the survey supports portal hypertension. High risk of PSC in IBD requires mandatory blood testing of biochemical parameters with the definition cholestasis in all patients with NUC and BC, and in its identification – the use of complex diagnostic tests to exclude PSC. Cholangiocellular carcinoma. Adenocarcinoma of the bile duct occurs in 1.5% of patients with NUC and 10% of patients PSC. In patients with NUC risk of cholangiocellular carcinoma is 20 times and seen 10 years earlier than people without IBD.
Diagnosis is often difficult, because the data ERCP is not always distinct from those with PSC. Fatty liver. The frequency of hepatic steatosis in patients with CD and NUC can reach 50%. Clinically, the disease is asymptomatic. It is believed that it should not be regarded as extraintestinal manifestation of IBD, and as a complication of corticosteroid therapy, the result of parenteral nutrition, malabsorption syndrome, sepsis. Autoimmune hepatitis. Autoimmune hepatitis is found in 1-5% of patients with IBD. When he NUC is more common than in CD. In patients with a combination of autoimmune disease and IBD autoimmune nature of the disease is confirmed by the detection of antinuclear antibodies, antibodies to smooth muscle, as well as the identification of other autoimmune diseases.