Clinical course of ulcerative colitis in patients with and without primary sclerosing cholangitis.
OBJECTIVE
We noticed in our practice that patients with ulcerative colitis (UC) who have developed primary sclerosing cholangitis (PSC) experience a milder course of colonic disease. Our objective in this study was to define whether or not there is any difference between UC activity and its course in patients with and without PSC.


METHODS
Nineteen patients with UC and PSC (eight male, mean age 25 years) were enrolled. To every patient with UC and PSC, three patients with UC alone (total of 57 patients, 28 male, mean age 24 years) matched for age at onset, duration of the disease and extension of colonic disease were selected as the control group. We used number of hospitalizations due to activity of UC and number of short corticosteroid administrations in various years of follow-up as variables indicating course and severity of the colonic disease in this period. For comparing trends of UC activity between two groups, we used repeated measures two-way analysis of variances.


RESULTS
Mean duration of follow up in case and control groups was 12.2 +/- 5.7 and 11.4 +/- 4.9 years, respectively. Two groups had no significant difference in use of sulfasalzine or aminosalicylates. Number of hospitalizations and courses of steroid therapy because of UC activity decreased significantly over time (P < 0.000) in both groups, and it was significantly higher in controls than in cases (P = 0.045 and 0.032, respectively).


CONCLUSIONS
Development of PSC in patients with UC might have a positive effect on colonic disease. Further investigations to evaluate the basis of this improvement are warranted.
Moayyeri
Alireza
A
Digestive Disease Research Center, Imam Hospital, Tehran University of Medical Sciences, Tehran, Iran. moayyeri@doctor.com
Daryani
Naser Ebrahimi
NE
Bahrami
Hossein
H
Haghpanah
Babak
B
Nayyer-Habibi
Atoosa
A
Sadatsafavi
Mohsen
M
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000328:Adult; D000636:Aminosalicylic Acids / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D016022:Case-Control Studies; D002648:Child; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control; D003093:Colitis, Ulcerative / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology*; D003110:Colonic Neoplasms / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D055502:Secondary Prevention; D012720:Severity of Illness Index; D012460:Sulfasalazine / Q000627:therapeutic use
D000305:Adrenal Cortex Hormones; D000636:Aminosalicylic Acids; D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D012460:Sulfasalazine