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Does the severity of primary sclerosing cholangitis influence the clinical course of associated ulcerative colitis?

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Názov: Does the severity of primary sclerosing cholangitis influence the clinical course of associated ulcerative colitis?
Autori: Marelli, L., Xirouchakis, E., Kalambokis, G., Cholongitas, E., Hamilton, M. I., Burroughs, A. K.
Zdroj: Gut. 60:1224-1228
Informácie o vydavateľovi: BMJ, 2011.
Rok vydania: 2011
Predmety: Azathioprine/administration & dosage, Adult, Male, Cholangitis, Sclerosing, Drug Administration Schedule, 03 medical and health sciences, 0302 clinical medicine, Azathioprine, Humans, Colitis, Ulcerative/*complications/drug therapy/surgery, Immunosuppressive Agents/administration & dosage, Glucocorticoids, Colectomy, Aged, Cholangitis, Sclerosing/*complications/surgery, Glucocorticoids/administration & dosage, Middle Aged, Prognosis, Liver Transplantation, 3. Good health, Colonic Neoplasms, Disease Progression, Colitis, Ulcerative, Female, Colonic Neoplasms/etiology, Immunosuppressive Agents, Follow-Up Studies
Popis: Ulcerative colitis (UC) associated with primary sclerosing cholangitis (PSC) is usually clinically mild. The aim of the study was to assess whether there is an association between severity of PSC and activity of UC, comparing the course of UC in patients with PSC not needing liver transplantation (LT) and those eventually transplanted.Between 1990 and 2009, 96 consecutive patients with PSC/UC were seen in the authors' institution. Data were evaluated from a database regarding UC activity (median follow-up 144 months). Follow-up was censored at time of LT or last clinical review.Patients with PSC/UC were divided into two groups: 46 did not need LT (no-LT) and 50 were transplanted (LT). There were no significant differences concerning duration of UC or PSC and extent of UC. The LT group had significantly (p=0.002) more clinically quiescent UC compared with the no-LT group. The LT group had fewer UC flare-ups (p=0.04) and required fewer steroid courses (p=0.025) with shorter duration (p=0.022) and less use of azathioprine (p=0.003). There was an increased need for surgery in the no-LT group (p=0.006). Colon carcinoma and high grade dysplasia were more frequent in the no-LT group (p=0.004). The no-LT group had increased inflammation in the colonic mucosa at histology (p=0.011), but without visual difference at colonoscopy.Clinically progressive PSC requiring LT is associated with a milder course of UC (reduced disease activity and less use of steroids, azathioprine and surgery). This is paralleled by less histological activity and reduced incidence of dysplasia and colon carcinoma.
Druh dokumentu: Article
Jazyk: English
ISSN: 0017-5749
DOI: 10.1136/gut.2010.235408
Prístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/21402617
http://gut.bmj.com/cgi/doi/10.1136/gut.2010.235408
http://gut.bmj.com/content/60/9/1224?60/9/1224
https://gut.bmj.com/content/60/9/1224
https://pubmed.ncbi.nlm.nih.gov/21402617/
https://gut.bmj.com/content/gutjnl/60/9/1224.full.pdf
https://www.ncbi.nlm.nih.gov/pubmed/21402617
http://olympias.lib.uoi.gr/jspui/handle/123456789/22363
Prístupové číslo: edsair.doi.dedup.....4e9ce534c396061ee8b50f9fca865dd6
Databáza: OpenAIRE
Popis
Abstrakt:Ulcerative colitis (UC) associated with primary sclerosing cholangitis (PSC) is usually clinically mild. The aim of the study was to assess whether there is an association between severity of PSC and activity of UC, comparing the course of UC in patients with PSC not needing liver transplantation (LT) and those eventually transplanted.Between 1990 and 2009, 96 consecutive patients with PSC/UC were seen in the authors' institution. Data were evaluated from a database regarding UC activity (median follow-up 144 months). Follow-up was censored at time of LT or last clinical review.Patients with PSC/UC were divided into two groups: 46 did not need LT (no-LT) and 50 were transplanted (LT). There were no significant differences concerning duration of UC or PSC and extent of UC. The LT group had significantly (p=0.002) more clinically quiescent UC compared with the no-LT group. The LT group had fewer UC flare-ups (p=0.04) and required fewer steroid courses (p=0.025) with shorter duration (p=0.022) and less use of azathioprine (p=0.003). There was an increased need for surgery in the no-LT group (p=0.006). Colon carcinoma and high grade dysplasia were more frequent in the no-LT group (p=0.004). The no-LT group had increased inflammation in the colonic mucosa at histology (p=0.011), but without visual difference at colonoscopy.Clinically progressive PSC requiring LT is associated with a milder course of UC (reduced disease activity and less use of steroids, azathioprine and surgery). This is paralleled by less histological activity and reduced incidence of dysplasia and colon carcinoma.
ISSN:00175749
DOI:10.1136/gut.2010.235408