Clinical course of ulcerative colitis in patients with and without primary sclerosing cholangitis

• Published in: Journal of gastroenterology and hepatology Vol. 20; no. 3; pp. 366 - 370
• Main Authors: MOAYYERI, ALIREZA, DARYANI, NASER EBRAHIMI, BAHRAMI, HOSSEIN, HAGHPANAH, BABAK, NAYYER-HABIBI, ATOOSA, SADATSAFAVI, MOHSEN
• Format: Journal Article
• Language: English
• Published: Melbourne, Australia Blackwell Science Pty 01.03.2005; Blackwell Science
• Subjects: Adolescent; Adrenal Cortex Hormones - therapeutic use; Adult; Aminosalicylic Acids - therapeutic use; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Biological and medical sciences; Case-Control Studies; case-control study; Child; Cholangitis, Sclerosing - diagnosis; Cholangitis, Sclerosing - physiopathology; Cholangitis, Sclerosing - prevention & control; clinical course; Colitis, Ulcerative - diagnosis; Colitis, Ulcerative - drug therapy; Colitis, Ulcerative - physiopathology; Colonic Neoplasms - etiology; colorectal cancer; Female; Follow-Up Studies; Gastroenterology. Liver. Pancreas. Abdomen; Hospitalization - statistics & numerical data; Humans; Immunosuppressive Agents - therapeutic use; Incidence; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; primary sclerosing cholangitis; Prognosis; Risk Factors; Secondary Prevention; Severity of Illness Index; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Sulfasalazine - therapeutic use; Tumors; ulcerative colitis; Human; clinical course; Rectal disease; Colorectal cancer; Malignant tumor; Case control study; Biliary tract disease; Inflammatory disease; Colonic disease; case-control study; Digestive diseases; Intestinal disease; Sclerosing cholangitis; primary sclerosing cholangitis; Ulcerative colitis
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2005.03727.x

Background and Aim: We noticed in our practice that patients with ulcerative colitis (UC) who have developed primary sclerosing cholangitis (PSC) experience a milder course of colonic disease. Our objective in this study was to define whether or not there is any difference between UC activity and its course in patients with and without PSC. Methods: Nineteen patients with UC and PSC (eight male, mean age 25 years) were enrolled. To every patient with UC and PSC, three patients with UC alone (total of 57 patients, 28 male, mean age 24 years) matched for age at onset, duration of the disease and extension of colonic disease were selected as the control group. We used number of hospitalizations due to activity of UC and number of short corticosteroid administrations in various years of follow‐up as variables indicating course and severity of the colonic disease in this period. For comparing trends of UC activity between two groups, we used repeated measures two‐way analysis of variances. Results: Mean duration of follow up in case and control groups was 12.2 ± 5.7 and 11.4 ± 4.9 years, respectively. Two groups had no significant difference in use of sulfasalzine or aminosalicylates. Number of hospitalizations and courses of steroid therapy because of UC activity decreased significantly over time (P < 0.000) in both groups, and it was significantly higher in controls than in cases (P = 0.045 and 0.032, respectively). Conclusions: Development of PSC in patients with UC might have a positive effect on colonic disease. Further investigations to evaluate the basis of this improvement are warranted.