Dissertation - Masters The Spectrum of Hepatic Involvment in Pediatric In Inflammatory Bowel Disease: An Analysis of the Development of Abnormal LiverĀ  Analysis of theĀ  Cl inical Variables

Author

Pamela Valentino

Abstract

Hepatic involvement in pediatric Inflammatory Bowel Diseases (IBD) includes presentation with abnormal liver enzymes (LEs). A proportion of these children do not develop serious hepatic consequences. We sought to describe the natural history of the development of abnormal LEs and associated clinical variables.

A carefully phenotyped cohort of 300 children with IBD (<18years) was selected. Clinical data, (medications, LEs), were recorded. The Kaplan-Meier method and Cox Proportional Hazards modeling were employed to describe the first episode of abnormal LEs and identify associated variables. The probability of developing abnormal LEs was 29.1% within 1year, and 47.6% within 5years, post IBD diagnosis. Children using corticosteroids or antibiotics were 70% (95% confidence interval [CI] 1.08, 2.66) and 362% (95%CI 2.96, 7.21) more likely to develop abnormal LEs, respectively. Similar associations were observed across various thresholds of LEs abnormalities. Overall, abnormal LEs are common in IBD and most often associated with medication use.


Supervisor

Brian Feldman