Skip to main content
Erschienen in: International Journal of Colorectal Disease 10/2018

09.07.2018 | Short Communication

Risk factors and clinical courses of concomitant primary sclerosing cholangitis and ulcerative colitis: a Korean multicenter study

verfasst von: Yong Eun Park, Jae Hee Cheon, Jae Jun Park, Yoon Jae Kim, Chang Hwan Choi, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim, MD

Erschienen in: International Journal of Colorectal Disease | Ausgabe 10/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

Primary sclerosing cholangitis (PSC) is a rare progressive cholestatic liver disease of unknown causes, but is strongly associated with inflammatory bowel diseases (IBDs), particularly ulcerative colitis (UC). However, studies comparing risk factors and clinical courses of patients with concomitant UC and PSC with those of patients with PSC alone are lacking.

Methods

We retrospectively reviewed patients with PSC diagnosed between 2005 and 2017 in four tertiary hospitals in Korea. We compared the risk factors and outcomes of concomitant UC and PSC (UC-PSC) and those of PSC alone.

Results

PSC was diagnosed in 50 patients in four different tertiary hospitals in Korea. Of them, 18 patients (36.0%) had UC-PSC and 32 patients (64.0%) had PSC alone. The median age at PSC diagnosis was younger in the UC-PSC group than that in the PSC alone group (37 vs. 54 years, P = 0.002). In multivariate analysis, older age at PSC diagnosis (P = 0.007; odds ratio [OR], 0.884; 95% confidence interval [CI], 0.808–0.966) and current smoking habit (P = 0.033; OR, 0.026; 95% CI, 0.001–0.748) were determined to be independent factors for reducing the possibility of developing concomitant UC after PSC. Additionally, UC-PSC was shown to be an independent risk factor for the development of colorectal dysplasia (P = 0.044; OR, 10.829; 95% CI, 1.065–110.127).

Conclusions

Our analysis showed that UC-PSC is more likely to be negatively associated with current smoking and older age at the time of PSC diagnosis. Moreover, UC-PSC increased the risk of colorectal dysplasia.
Literatur
2.
Zurück zum Zitat Hirschfield GM, Karlsen TH, Lindor KD, Adams DH (2013) Primary sclerosing cholangitis. Lancet 382(9904):1587–1599CrossRefPubMed Hirschfield GM, Karlsen TH, Lindor KD, Adams DH (2013) Primary sclerosing cholangitis. Lancet 382(9904):1587–1599CrossRefPubMed
3.
Zurück zum Zitat Palmela C, Peerani F, Castaneda D, Torres J, Itzkowitz SH (2018) Inflammatory bowel disease and primary sclerosing cholangitis: a review of the phenotype and associated specific features. Gut Liver 12(1):17–29CrossRefPubMed Palmela C, Peerani F, Castaneda D, Torres J, Itzkowitz SH (2018) Inflammatory bowel disease and primary sclerosing cholangitis: a review of the phenotype and associated specific features. Gut Liver 12(1):17–29CrossRefPubMed
4.
Zurück zum Zitat Lazaridis KN, LaRusso NF (2016) Primary sclerosing cholangitis. N Engl J Med 375(25):2501–2502PubMed Lazaridis KN, LaRusso NF (2016) Primary sclerosing cholangitis. N Engl J Med 375(25):2501–2502PubMed
5.
Zurück zum Zitat Boonstra K, van Erpecum KJ, van Nieuwkerk KM, Drenth JP, Poen AC, Witteman BJ, Tuynman HA, Beuers U, Ponsioen CY (2012) Primary sclerosing cholangitis is associated with a distinct phenotype of inflammatory bowel disease. Inflamm Bowel Dis 18(12):2270–2276CrossRefPubMed Boonstra K, van Erpecum KJ, van Nieuwkerk KM, Drenth JP, Poen AC, Witteman BJ, Tuynman HA, Beuers U, Ponsioen CY (2012) Primary sclerosing cholangitis is associated with a distinct phenotype of inflammatory bowel disease. Inflamm Bowel Dis 18(12):2270–2276CrossRefPubMed
6.
Zurück zum Zitat Boberg KM, Aadland E, Jahnsen J, Raknerud N, Stiris M, Bell H (1998) Incidence and prevalence of primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis in a Norwegian population. Scand J Gastroenterol 33(1):99–103CrossRefPubMed Boberg KM, Aadland E, Jahnsen J, Raknerud N, Stiris M, Bell H (1998) Incidence and prevalence of primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis in a Norwegian population. Scand J Gastroenterol 33(1):99–103CrossRefPubMed
7.
Zurück zum Zitat Kaplan GG, Laupland KB, Butzner D, Urbanski SJ, Lee SS (2007) The burden of large and small duct primary sclerosing cholangitis in adults and children: a population-based analysis. Am J Gastroenterol 102(5):1042–1049CrossRefPubMed Kaplan GG, Laupland KB, Butzner D, Urbanski SJ, Lee SS (2007) The burden of large and small duct primary sclerosing cholangitis in adults and children: a population-based analysis. Am J Gastroenterol 102(5):1042–1049CrossRefPubMed
8.
Zurück zum Zitat Hashimoto E, Ideta M, Taniai M, Watanabe U, Okuda H, Nagasako K, Hisamitsu T, Obata H (1993) Prevalence of primary sclerosing cholangitis and other liver diseases in Japanese patients with chronic ulcerative colitis. J Gastroenterol Hepatol 8(2):146–149CrossRefPubMed Hashimoto E, Ideta M, Taniai M, Watanabe U, Okuda H, Nagasako K, Hisamitsu T, Obata H (1993) Prevalence of primary sclerosing cholangitis and other liver diseases in Japanese patients with chronic ulcerative colitis. J Gastroenterol Hepatol 8(2):146–149CrossRefPubMed
9.
Zurück zum Zitat Ye BD, Yang SK, Boo SJ, Cho YK, Yang DH, Yoon SM, Kim KJ, Byeon JS, Myung SJ, Yu CS, Yun SC, Kim JH (2011) Clinical characteristics of ulcerative colitis associated with primary sclerosing cholangitis in Korea. Inflamm Bowel Dis 17(9):1901–1906CrossRefPubMed Ye BD, Yang SK, Boo SJ, Cho YK, Yang DH, Yoon SM, Kim KJ, Byeon JS, Myung SJ, Yu CS, Yun SC, Kim JH (2011) Clinical characteristics of ulcerative colitis associated with primary sclerosing cholangitis in Korea. Inflamm Bowel Dis 17(9):1901–1906CrossRefPubMed
10.
Zurück zum Zitat Fraga M, Fournier N, Safroneeva E, Pittet V, Godat S, Straumann A, Nydegger A, Vavricka SR, Moradpour D, Schoepfer AM (2017) Primary sclerosing cholangitis in the Swiss Inflammatory Bowel Disease Cohort Study: prevalence, risk factors, and long-term follow-up. Eur J Gastroenterol Hepatol 29(1):91–97CrossRefPubMed Fraga M, Fournier N, Safroneeva E, Pittet V, Godat S, Straumann A, Nydegger A, Vavricka SR, Moradpour D, Schoepfer AM (2017) Primary sclerosing cholangitis in the Swiss Inflammatory Bowel Disease Cohort Study: prevalence, risk factors, and long-term follow-up. Eur J Gastroenterol Hepatol 29(1):91–97CrossRefPubMed
11.
Zurück zum Zitat Ludwig J, Barham SS, LaRusso NF, Elveback LR, Wiesner RH, McCall JT (1981) Morphologic features of chronic hepatitis associated with primary sclerosing cholangitis and chronic ulcerative colitis. Hepatology 1(6):632–640CrossRefPubMed Ludwig J, Barham SS, LaRusso NF, Elveback LR, Wiesner RH, McCall JT (1981) Morphologic features of chronic hepatitis associated with primary sclerosing cholangitis and chronic ulcerative colitis. Hepatology 1(6):632–640CrossRefPubMed
12.
Zurück zum Zitat Glowacki MK, Zwolinska-Wcislo M, Fraczek P, Gomulska M, Owczarek D, Cibor D, Ciesla A, Mach T (2015) Clinical course of primary sclerosing cholangitis and concomitant ulcerative colitis—a preliminary report of retrospective study among patients from Southern Poland. Folia Med Cracov 55(2):61–68PubMed Glowacki MK, Zwolinska-Wcislo M, Fraczek P, Gomulska M, Owczarek D, Cibor D, Ciesla A, Mach T (2015) Clinical course of primary sclerosing cholangitis and concomitant ulcerative colitis—a preliminary report of retrospective study among patients from Southern Poland. Folia Med Cracov 55(2):61–68PubMed
Metadaten
Titel
Risk factors and clinical courses of concomitant primary sclerosing cholangitis and ulcerative colitis: a Korean multicenter study
verfasst von
Yong Eun Park
Jae Hee Cheon
Jae Jun Park
Yoon Jae Kim
Chang Hwan Choi
Yehyun Park
Soo Jung Park
Tae Il Kim
Won Ho Kim, MD
Publikationsdatum
09.07.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
International Journal of Colorectal Disease / Ausgabe 10/2018
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-018-3123-6

Weitere Artikel der Ausgabe 10/2018

International Journal of Colorectal Disease 10/2018 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

Karpaltunnelsyndrom BDC Leitlinien Webinare
CME: 2 Punkte

Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

Radiusfraktur BDC Leitlinien Webinare
CME: 2 Punkte

Das Webinar beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

Appendizitis BDC Leitlinien Webinare
CME: 2 Punkte

Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.