title: Isolated ileitis associated with primary sclerosing cholangitis in three patients with Crohn's disease.
abstract: BACKGROUND
  Primary sclerosing cholangitis (PSC) is associated with ulcerative colitis and extensive colonic involvement or ileocolitis in Crohn's disease (CD). To our knowledge, no specific report of isolated ileitis associated with PSC in CD patients has been published in CD patients.
  
  
  OBJECTIVE
  We report three cases of patients with isolated Crohn's ileitis associated with PSC and in whom colonic inflammation was never documented.
  
  
  RESULTS
  Patients were followed up 10-23 years and each patient underwent 6-7 ileocolonoscopies: inflammation was located only in the terminal ileum, which was confirmed on surgical specimens in two patients. Small-duct PSC led to diagnosis of CD ileitis in one patient, while small and large-ducts PSC were evidenced after CD diagnosis in the other 2. PSC were regularly followed for 9-10 years.
  
  
  CONCLUSIONS
  Our three cases of PSC with isolated CD ileitis and long-term follow-up without any sign of colonic involvement argue against the concept that colonic mucosal inflammation is critical for the pathogenesis of PSC in inflammatory bowel disease.
authors.affiliation: a Trousseau Hospital and Rabelais University, Tours , France ;
authors.forename: Driffa
authors.initials: D
authors.lastname: Moussata
authors.affiliation: b Lyon Sud Hospital and University Claude Bernard Lyon , Pierre Béite , France ;
authors.forename: Gilles
authors.initials: G
authors.lastname: Boschetti
authors.affiliation: b Lyon Sud Hospital and University Claude Bernard Lyon , Pierre Béite , France ;
authors.forename: Carmen
authors.initials: C
authors.lastname: Stefanescu
authors.affiliation: b Lyon Sud Hospital and University Claude Bernard Lyon , Pierre Béite , France ;
authors.forename: Stephane
authors.initials: S
authors.lastname: Nancey
authors.affiliation: c Beaujon Hospital, Assistance Publique des Hôpitaux de Paris and University Diderot , Paris , France.
authors.forename: Yoram
authors.initials: Y
authors.lastname: Bouhnik
authors.affiliation: b Lyon Sud Hospital and University Claude Bernard Lyon , Pierre Béite , France ;
authors.forename: Bernard
authors.initials: B
authors.lastname: Flourie
mesh_terms: D000328:Adult; D000368:Aged; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000175:diagnosis; D003424:Crohn Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D006801:Humans; D007079:Ileitis / Q000150:complications* / Q000175:diagnosis; D008875:Middle Aged
keywords: Crohn’s disease; ileitis; primary sclerosing cholangitis