title: Forty-six patients with primary sclerosing cholangitis: radiological bile duct changes in relationship to clinical course and concomitant inflammatory bowel disease.
abstract: The clinical features of primary sclerosing cholangitis were studied in 46 consecutive patients. Jaundice was the most common symptom (57%), followed by pruritus (28%), pain (24%), and fever (15%). Thirty-three per cent of the patients had no symptoms, merely laboratory changes. No significant relationship was observed between a numerical score of radiological bile duct changes at diagnosis and the clinical picture, or the clinical course during follow-up. If clinical deterioration occurred, this seemed to happen within the first eight years after the clinical presentation. Patients with only intra-hepatic bile duct changes (n = 10) did not differ clinically from those with extrahepatic changes as well. Forty-three out of 44 patients examined had inflammatory bowel disease, usually ulcerative colitis, with total colitis in 84%. Radiological bile duct changes had a significantly higher score in patients who had to be treated with a combination of sulfasalazine and steroids, suggesting a weak relationship between severity of bowel disease and bile duct disease.
authors.affiliation: Department of Medicine II, Sahlgrenska Hospital, University of Göteborg, Sweden.
authors.forename: R W
authors.initials: RW
authors.lastname: Stockbrügger
authors.forename: R
authors.initials: R
authors.lastname: Olsson
authors.forename: B
authors.initials: B
authors.lastname: Jaup
authors.forename: J
authors.initials: J
authors.lastname: Jensen
mesh_terms: D000328:Adult; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging*; D002758:Cholangiography; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged