Paradoxical progression of biliary strictures against recovery of biochemical parameters under ursodeoxycholic acid treatment in a case of primary sclerosing cholangitis with ulcerative colitis.
Ursodeoxycholic acid (UDCA) treatment for primary sclerosing cholangitis (PSC) has been considered a rational therapy, though its effectiveness in the clinical course is still open to discussion. In this report, we describe a 22-year-old man with PSC at an early stage, which was associated with ulcerative colitis (UC). He showed progressive strictures of bile ducts over a 1.5-year period in spite of an improvement in the biochemical parameters by UDCA treatment. Therefore, care should be taken in interpreting the effectiveness of UDCA, because the biochemical parameters may not change in parallel with the clinical course of PSC.
Komatsu
K
K
Department of Gastroenterology and Internal Medicine, Miyagi Social Insurance Hospital, Sendai.
Shimosegawa
T
T
Kikuchi
S
S
Uchi
M
M
Maruhama
Y
Y
Kisara
N
N
Ueno
Y
Y
Toyota
T
T
D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D001623:Betamethasone / Q000627:therapeutic use; D001652:Bile Ducts / Q000473:pathology; D001706:Biopsy; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D003093:Colitis, Ulcerative / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D003113:Colonoscopy; D018450:Disease Progression; D004359:Drug Therapy, Combination; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use; D011239:Prednisolone / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use*
D000893:Anti-Inflammatory Agents; D019268:Antibodies, Antineutrophil Cytoplasmic; D007166:Immunosuppressive Agents; D019804:Mesalamine; D014580:Ursodeoxycholic Acid; D001623:Betamethasone; D011239:Prednisolone