Intest Res.  2022 Apr;20(2):224-230. 10.5217/ir.2021.00042.

Association of young age and male sex with primary sclerosing cholangitis in Taiwanese patients with inflammatory bowel disease

Affiliations
  • 1Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
  • 2Department of Medical Imaging, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
  • 3Department of Integrated Diagnostics and Therapeutics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
  • 4Good Liver Clinic, Taipei City, Taiwan
  • 5Department of Oncology, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan
  • 6Department of Pediatrics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei City, Taiwan

Abstract

Background/Aims
Primary sclerosing cholangitis (PSC) is associated with inflammatory bowel disease (IBD). We aimed to evaluate the prevalence, clinical manifestation, and outcomes of PSC in Taiwanese patients with IBD. Methods: This retrospective study enrolled patients with IBD admitted from January 1, 1996, to December 31, 2018, to National Taiwan University Hospital. A case-matched analysis was performed comparing patients with IBD with and without PSC according to age, sex, and time of admission, with ratios of 1:4 and 1:2 in the adult and pediatric groups, respectively.
Results
In total, 763 patients with IBD were enrolled, 12 of whom were also diagnosed with PSC (1.57%). All these patients had ulcerative colitis (UC). A greater incidence of IBD with PSC was observed in younger patients than in older patients. Male sex was a risk factor for PSC in pediatric patients with IBD (P=0.015); 75% of these patients were diagnosed with PSC along with or after the diagnosis of UC. There was no significant difference in colitis extent and severity between the groups; however, a higher proportion of rectal sparing was observed in patients with PSC (P=0.001). There was no significant difference in cancer development between the groups (P=0.679). Conclusions: A 1.57% prevalence of PSC was observed in Taiwanese patients with IBD. The majority of patients with IBD and PSC were men and were diagnosed at a younger age. Hence, routine evaluation of biliary enzymes and liver imaging is recommended in young male patients with IBD.

Keyword

Primary sclerosing cholangitis; Inflammatory bowel disease; Ulcerative colitis

Cited by  3 articles

Is primary sclerosing cholangitis with inflammatory bowel disease different between patients in the East and West?
Yong Eun Park
Intest Res. 2022;20(2):157-158.    doi: 10.5217/ir.2022.00041.

Treatment of primary sclerosing cholangitis combined with inflammatory bowel disease
You Sun Kim, Edward H. Hurley, Yoojeong Park, Sungjin Ko
Intest Res. 2023;21(4):420-432.    doi: 10.5217/ir.2023.00039.

Regional variations in the prevalence of primary sclerosing cholangitis associated with inflammatory bowel disease
Kwang Woo Kim, Hyoun Woo Kang
Intest Res. 2023;21(4):413-414.    doi: 10.5217/ir.2023.00133.


Reference

1. Boonstra K, Beuers U, Ponsioen CY. Epidemiology of primary sclerosing cholangitis and primary biliary cirrhosis: a systematic review. J Hepatol. 2012; 56:1181–1188.
Article
2. Boonstra K, Weersma RK, van Erpecum KJ, et al. Populationbased epidemiology, malignancy risk, and outcome of primary sclerosing cholangitis. Hepatology. 2013; 58:2045–2055.
Article
3. Karlsen TH, Folseraas T, Thorburn D, Vesterhus M. Primary sclerosing cholangitis: a comprehensive review. J Hepatol. 2017; 67:1298–1323.
4. de Vries AB, Janse M, Blokzijl H, Weersma RK. Distinctive inflammatory bowel disease phenotype in primary sclerosing cholangitis. World J Gastroenterol. 2015; 21:1956–1971.
Article
5. Yang BR, Choi NK, Kim MS, et al. Prevalence of extraintestinal manifestations in Korean inflammatory bowel disease patients. PLoS One. 2018; 13:e0200363.
Article
6. Vavricka SR, Rogler G, Gantenbein C, et al. Chronological order of appearance of extraintestinal manifestations relative to the time of IBD diagnosis in the Swiss Inflammatory Bowel Disease Cohort. Inflamm Bowel Dis. 2015; 21:1794–1800.
Article
7. Folseraas T, Boberg KM. Cancer risk and surveillance in primary sclerosing cholangitis. Clin Liver Dis. 2016; 20:79–98.
Article
8. Truelove SC, Witts LJ. Cortisone in ulcerative colitis; preliminary report on a therapeutic trial. Br Med J. 1954; 2:375–378.
Article
9. Núñez F P, Quera P R, Gomollón F. Primary sclerosing cholangitis and inflammatory bowel disease: intestine-liver interrelation. Gastroenterol Hepatol. 2019; 42:316–325.
Article
10. Yen HH, Weng MT, Tung CC, et al. Epidemiological trend in inflammatory bowel disease in Taiwan from 2001 to 2015: a nationwide populationbased study. Intest Res. 2019; 17:54–62.
Article
11. Wei SC, Shieh MJ, Chang MC, Chang YT, Wang CY, Wong JM. Long-term follow-up of ulcerative colitis in Taiwan. J Chin Med Assoc. 2012; 75:151–155.
Article
12. Dignass A, Eliakim R, Magro F, et al. Second European evidence-based consensus on the diagnosis and management of ulcerative colitis part 1: definitions and diagnosis. J Crohns Colitis. 2012; 6:965–990.
Article
13. Lin WC, Weng MT, Tung CC, et al. Trends and risk factors of mortality analysis in patients with inflammatory bowel disease: a Taiwanese nationwide population-based study. J Transl Med. 2019; 17:414.
Article
14. Singh B, Kedia S, Konijeti G, et al. Extraintestinal manifestations of inflammatory bowel disease and intestinal tuberculosis: frequency and relation with disease phenotype. Indian J Gastroenterol. 2015; 34:43–50.
Article
15. Fagundes ED, Ferreira AR, Hosken CC, Queiroz TC. Primary sclerosing cholangitis in children and adolescents. Arq Gastroenterol. 2017; 54:286–291.
Article
16. Fousekis FS, Theopistos VI, Mitselos IV, et al. Specific features of patients with inflammatory bowel disease and primary sclerosing cholangitis. J Clin Med Res. 2019; 11:81–88.
Article
17. Bajer L, Wohl P, Drastich P. PSC-IBD: specific phenotype of inflammatory bowel disease associated with primary sclerosing cholangitis. Vnitr Lek. 2018; 64:659–664.
Article
18. Chou JW, Lai HC, Chang CH, Cheng KS, Feng CL, Chen TW. Epidemiology and clinical outcomes of inflammatory bowel disease: a hospital-based study in central Taiwan. Gastroenterol Res Pract. 2019; 2019:4175923.
Article
19. Park SH, Yang SK, Park SK, et al. Atypical distribution of inflammation in newly diagnosed ulcerative colitis is not rare. Can J Gastroenterol Hepatol. 2014; 28:125–130.
Article
20. Horio Y, Uchino M, Bando T, et al. Rectal-sparing type of ulcerative colitis predicts lack of response to pharmacotherapies. BMC Surg. 2017; 17:59.
Article
21. Ricciuto A, Kamath BM, Griffiths AM. The IBD and PSC phenotypes of PSC-IBD. Curr Gastroenterol Rep. 2018; 20:16.
Article
22. Palmela C, Peerani F, Castaneda D, Torres J, Itzkowitz SH. Inflammatory bowel disease and primary sclerosing cholangitis: a review of the phenotype and associated specific features. Gut Liver. 2018; 12:17–29.
Article
23. Jess T, Rungoe C, Peyrin-Biroulet L. Risk of colorectal cancer in patients with ulcerative colitis: a meta-analysis of population-based cohort studies. Clin Gastroenterol Hepatol. 2012; 10:639–645.
Article
24. Zheng HH, Jiang XL. Increased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and inflammatory bowel disease: a meta-analysis of 16 observational studies. Eur J Gastroenterol Hepatol. 2016; 28:383–390.
Article
25. Weismüller TJ, Trivedi PJ, Bergquist A, et al. Patient age, sex, and inflammatory bowel disease phenotype associate with course of primary sclerosing cholangitis. Gastroenterology. 2017; 152:1975–1984.
Full Text Links
  • IR
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr