| Inflammatory bowel disease in patients with primary sclerosing cholangitis: Clinical characterization in liver transplanted and nontransplanted patients. | |
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MedLine Citation:
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PMID: 21456044 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Inflammatory bowel disease (IBD) in patients with primary sclerosing cholangitis (PSC) seems to differ from IBD without PSC, but a systematic, prospective study of IBD in PSC has until now not been reported. We aimed to describe the clinical, endoscopic, and histopathologic features of PSC-IBD in liver-transplanted and nontransplanted patients. METHODS: PSC patients (n = 184) were included and underwent ileocolonoscopy with assessment of segmental histopathology. RESULTS: A total of 155 (84%) patients had IBD, of whom 39 (25%) had undergone colectomy. The patients with an intact colon and complete tissue samples (n = 110) were further investigated. Forty-two (38%) patients had undergone liver transplantation. The median IBD duration was 11 (range, 0-50) years. The majority (65%) had no or sparse IBD symptoms. Inflammatory findings were more frequent by histology than by endoscopy (89% versus 47%, P < 0.001). Histopathological signs of inflammation involved the right colon in 86% of patients and were purely right-sided in 23%. The findings of inflammation were higher in the right compared to the left colon (P < 0.001), but the general inflammatory activity was low. Backwash ileitis was demonstrated in 20% (17/87) of patients and rectal sparing in 65% (70/107). The liver-transplanted patients had lower clinical (P = 0.035) and histological (P = 0.013) IBD activity than the nontransplanted group. CONCLUSIONS: PSC-IBD may represent a distinct entity of colitis in which low endoscopic activity may mask an active histologic inflammation that possibly contributes to an increased risk of malignancy. Circumstances related to liver transplantation seem to act favorably on colonic inflammation in PSC. (Inflamm Bowel Dis 2011;). |
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Authors:
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Kristin Kaasen Jørgensen; Krzysztof Grzyb; Knut E A Lundin; Ole Petter F Clausen; Geir Aamodt; Erik Schrumpf; Morten H Vatn; Kirsten Muri Boberg |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-31 |
Journal Detail:
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Title: Inflammatory bowel diseases Volume: - ISSN: 1536-4844 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-4-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9508162 Medline TA: Inflamm Bowel Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 Crohn's & Colitis Foundation of America, Inc. |
Affiliation:
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*Norwegian PSC Research Center, Clinic for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway; Endoscopy unit, Clinic for Specialized Medicine and Surgery, Oslo University Hospital, Rikshospitalet, Oslo, Norway. kristin.kaasen.jorgensen@rikshospitalet.no. |
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