title: Contrasting Pattern of Chronic Inflammatory Bowel Disease in Primary and Autoimmune Sclerosing Cholangitis.
abstract: BACKGROUND
  Primary sclerosing cholangitis (PSC) and autoimmune sclerosing cholangitis (AISC) are related, but distinct chronic liver diseases. PSC is associated with a high prevalence of ulcerative colitis while the intestinal inflammation associated with AISC is less well characterised.
  
  
  OBJECTIVE
  To assess and contrast aspects of intestinal inflammation in patients with AISC and PSC and compare the clinical features with those of patients with ulcerative colitis and Crohn's disease.
  
  
  METHODS
  23 and 22 patients with AISC and PSC, respectively, underwent review of colonoscopy and biopsy findings, capsule enteroscopy and assessment of clinical and inflammatory (faecal calprotectin) disease activity, which was compared with that of patients with ulcerative colitis and Crohn's disease (n = 55 each).
  
  
  RESULTS
  Five and 6 patients with AISC and PSC, respectively, had normal colonoscopy and faecal calprotectin levels of 34.4 ± 8.3 and 39.7 ± 8.4 μg/g, respectively (normal < 50 μg/g), whereas 18 and 16, respectively, had identical variably severe, right sided colitis with frequent rectal sparing, consistent with ulcerative colitis. Mean (± SD) faecal calprotectin levels did not differ significantly (p > 0.05) between patients with intestinal inflammation in AISC (588 ± 549 μg/g), PSC (421 ± 351 μg/g), ulcerative colitis (501 ± 656 μg/g) or Crohn's disease (476 ± 571 μg/g). Capsule enteroscopy showed that 7 of 18 (39%) (p < 0.03) of those with AISC had small bowel mucosal breaks whereas no patient with PSC had these findings.
  
  
  CONCLUSIONS
  Collectively these findings lend support to the suggestion that the chronic inflammatory bowel disease associated with PSC and in particular AISC may represent a distinct nosologic entity different from classic ulcerative colitis and Crohn's disease.
authors.affiliation: Department of Gastroenterology, King's College Hospital, Denmark Hill, London, UK ; Department of Minimally Invasive Colorectal Surgery, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Ingvar
authors.initials: I
authors.lastname: Bjarnason
authors.affiliation: Department of Gastroenterology, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Bu
authors.initials: B
authors.lastname: Hayee
authors.affiliation: Department of Gastroenterology, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Polychronis
authors.initials: P
authors.lastname: Pavlidis
authors.affiliation: Department of Minimally Invasive Colorectal Surgery, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Kvasnovsky
authors.affiliation: Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Astrid
authors.initials: A
authors.lastname: Scalori
authors.affiliation: Department of Gastroenterology, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Guy
authors.initials: G
authors.lastname: Sisson
authors.affiliation: Department of Gastroenterology, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Annika
authors.initials: A
authors.lastname: Charlesworth
authors.affiliation: Department of Histopathology, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Hizbullah
authors.initials: H
authors.lastname: Shaikh
authors.affiliation: Department of Gastroenterology, Landspitali University Hospital, Reykjavik, Iceland.
authors.forename: Einar
authors.initials: E
authors.lastname: Bjornsson
authors.affiliation: Institute of Liver Studies, King's College Hospital, Denmark Hill, London, UK.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Heneghan
mesh_terms: D000293:Adolescent; D000328:Adult; D001706:Biopsy; D002648:Child; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D003093:Colitis, Ulcerative / Q000150:complications / Q000175:diagnosis; D003113:Colonoscopy; D003424:Crohn Disease / Q000150:complications / Q000175:diagnosis; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications* / Q000175:diagnosis* / Q000188:drug therapy; D007413:Intestinal Mucosa / Q000473:pathology; D039841:Leukocyte L1 Antigen Complex; D008297:Male; D008875:Middle Aged; D055815:Young Adult
chemical_list: D039841:Leukocyte L1 Antigen Complex
keywords: Autoimmune sclerosing cholangitis; Capsule enteroscopy; Chronic liver disease; Crohn's disease; Enteropathy; Inflammatory bowel disease; Primary sclerosing cholangitis; Ulcerative colitis