Does colitis associated with primary sclerosing cholangitis represent an actual subset of ulcerative colitis?
OBJECTIVE
The clinical course and endoscopic features of colitis associated with primary sclerosing cholangitis have not been well documented.


METHODS
Since 1980, a total of 485 patients with ulcerative colitis have been seen in our departments. During this period, we experienced 6 patients with primary sclerosing cholangitis, 4 of whom had ulcerative colitis concomitantly.


RESULTS
Colitis preceded primary sclerosing cholangitis in 3 of the 4 patients. There were 2 males and 2 females. One patient had left-sided colitis while 3 had total colitis, 1 with a first attack and 3 with relapsing-remitting type. Two of the 4 patients had colonoscopically dominant inflammation in the proximal colon with continuous histological inflammation from the rectum to the proximal colon. Three colitic patients have been well controlled with oral sulfasalzine or mesalazine administration. Only 1 female patient had been hospitalized twice for moderately severe attacks of ulcerative colitis that required systemic prednisolone administration, however, this patient quickly responded to this treatment for each admission.


CONCLUSIONS
Colitis associated with primary sclerosing cholangitis exhibited atypical colonoscopic findings and exhibited milder disease activity than ulcerative colitis without primary sclerosing cholangitis.
Oshitani
Nobuhide
N
Department of Gastroenterology, Osaka City University Post Graduate School of Medicine, 1-4-3, Asahi-machi, Abeno-ku, Osaka 545-8585, Japan.
Jinno
Yoshio
Y
Sawa
Yoshinori
Y
Nakamura
Shiro
S
Matsumoto
Takayuki
T
Nishiguchi
Shuhei
S
Seki
Shuichi
S
Higuchi
Kazuhide
K
Arakawa
Tetsuo
T
D000328:Adult; D015209:Cholangitis, Sclerosing / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003092:Colitis / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology; D003113:Colonoscopy; D015897:Comorbidity; D005260:Female; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged