Clinical features of primary sclerosing cholangitis with onset age above 50 years.
BACKGROUND
Although there are two peaks in the age distribution of primary sclerosing cholangitis (PSC) in Japan, the clinical differences between the patients with an older or younger onset age have not been reported.


METHODS
We compared clinical features of 18 patients with onset age less than 50 years (younger group) and ten PSC patients with onset age above 50 years (older group).


RESULTS
An association with ulcerative colitis (UC) was recognized in six patients in the younger group and in one in the older group. High serum IgE (>170 IU/ml) was observed more frequently in the older than in the younger group (1/10 vs. 7/8, P = 0.0029). Mean serum IgM tended to be higher in the younger group (198 vs. 119 mg/dl, P = 0.083). More patients received liver transplantation or continuous bile drainage, or developed liver failure or cholangiocellular carcinoma in the younger than in the older group (11/18 vs. 1/10, P = 0.016).


CONCLUSIONS
Older PSC patients have higher IgE, possibly less association with UC, lower IgM, and a better prognosis. The pathogenesis of PSC may be different between older and younger patients.
Hirano
Kenji
K
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Tada
Minoru
M
Isayama
Hiroyuki
H
Yashima
Yoko
Y
Yagioka
Hiroshi
H
Sasaki
Takashi
T
Kogure
Hirofumi
H
Togawa
Osamu
O
Arizumi
Toshihiko
T
Matsubara
Saburo
S
Nakai
Yousuke
Y
Sasahira
Naoki
N
Tsujino
Takeshi
T
Kawabe
Takao
T
Omata
Masao
M
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D002648:Child; D015209:Cholangitis, Sclerosing / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000276:immunology; D003093:Colitis, Ulcerative / Q000150:complications; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D055815:Young Adult
D007073:Immunoglobulin E