TY - JOUR
T1 - Primary sclerosing cholangitis associated colitis
T2 - Characterization of clinical, histologic features, and their associations with liver transplantation
AU - Aranake-Chrisinger, John
AU - Dassopoulos, Themistocles
AU - Yan, Yan
AU - Nalbantoglu, Ilke
N1 - Funding Information:
A portion of this work was presented at the 2015 United States and Canadian Academy of Pathology Annual Meeting in Boston, MA. The authors would like to acknowledge the support of Department of Pathology and Immunology, Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University in St. Louis, School of Medicine for this study and Washington University in St. Louis School of Medicine Anatomic and Molecular Pathology (AMP) Laboratory for the technical support.
Publisher Copyright:
©The Author(s) 2020.
PY - 2020/7/28
Y1 - 2020/7/28
N2 - BACKGROUND Primary sclerosing cholangitis (PSC) associated inflammatory bowel disease (IBD) is a unique form of IBD (PSC-IBD) with distinct clinical and histologic features from ulcerative colitis (UC) and Crohn disease (CD). In patients with PSC and IBD, the severity of the two disease processes may depend on each other. AIM To study the histologic and clinical features of PSC patients with and without IBD. METHODS We assessed specimens from patients with UC (n = 28), CD (n = 10), PSC and UC (PSC-UC; n = 26); PSC and CD (PSC-CD; n = 6); and PSC and no IBD (PSC-no IBD; n = 4) between years 1999-2013. PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration. Clinical data including age, gender, age at IBD and PSC diagnoses, IBD duration, treatment, follow-up, orthotopic liver transplantation (OLT) were noted. RESULTS PSC-UC patients had more isolated right-sided disease (P = 0.03), and less active inflammation in left colon, rectum (P = 0.03 and P = 0.0006), and overall (P = 0.0005) compared to UC. They required less steroids (P = 0.01) and fewer colectomies (P = 0.03) than UC patients. The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD. No PSC-CD patients required OLT compared to 38% of PSC-UC (P = 0.1). PSC-IBD (PSC-UC and PSCCD) patients with OLT had severe disease in the left colon and rectum (P = 0.04). CONCLUSION PSC-UC represents a distinct form of IBD. The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction, however warrants clinical attention and further research.
AB - BACKGROUND Primary sclerosing cholangitis (PSC) associated inflammatory bowel disease (IBD) is a unique form of IBD (PSC-IBD) with distinct clinical and histologic features from ulcerative colitis (UC) and Crohn disease (CD). In patients with PSC and IBD, the severity of the two disease processes may depend on each other. AIM To study the histologic and clinical features of PSC patients with and without IBD. METHODS We assessed specimens from patients with UC (n = 28), CD (n = 10), PSC and UC (PSC-UC; n = 26); PSC and CD (PSC-CD; n = 6); and PSC and no IBD (PSC-no IBD; n = 4) between years 1999-2013. PSC-IBD patients were matched to IBD patients without PSC by age and colitis duration. Clinical data including age, gender, age at IBD and PSC diagnoses, IBD duration, treatment, follow-up, orthotopic liver transplantation (OLT) were noted. RESULTS PSC-UC patients had more isolated right-sided disease (P = 0.03), and less active inflammation in left colon, rectum (P = 0.03 and P = 0.0006), and overall (P = 0.0005) compared to UC. They required less steroids (P = 0.01) and fewer colectomies (P = 0.03) than UC patients. The PSC-CD patients had more ileitis and less rectal involvement compared to PSC-UC and CD. No PSC-CD patients required OLT compared to 38% of PSC-UC (P = 0.1). PSC-IBD (PSC-UC and PSCCD) patients with OLT had severe disease in the left colon and rectum (P = 0.04). CONCLUSION PSC-UC represents a distinct form of IBD. The different disease phenotype in PSC-IBD patients with OLT may support liver-gut axis interaction, however warrants clinical attention and further research.
KW - Clinical associations
KW - Inflammation
KW - Inflammatory bowel disease
KW - Liver transplantation
KW - Pathologic features
KW - Primary sclerosing cholangitis
UR - http://www.scopus.com/inward/record.url?scp=85089799222&partnerID=8YFLogxK
U2 - 10.3748/wjg.v26.i28.4126
DO - 10.3748/wjg.v26.i28.4126
M3 - Article
C2 - 32821074
AN - SCOPUS:85089799222
SN - 1007-9327
VL - 26
SP - 4126
EP - 4139
JO - World Journal of Gastroenterology
JF - World Journal of Gastroenterology
IS - 28
ER -