Skip to main content

Advertisement

SpringerLink
Log in

Risk factors and clinical courses of concomitant primary sclerosing cholangitis and ulcerative colitis: a Korean multicenter study

  • Short Communication
  • Published:
International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

Primary sclerosing cholangitis (PSC) is a rare progressive cholestatic liver disease of unknown causes, but is strongly associated with inflammatory bowel diseases (IBDs), particularly ulcerative colitis (UC). However, studies comparing risk factors and clinical courses of patients with concomitant UC and PSC with those of patients with PSC alone are lacking.

Methods

We retrospectively reviewed patients with PSC diagnosed between 2005 and 2017 in four tertiary hospitals in Korea. We compared the risk factors and outcomes of concomitant UC and PSC (UC-PSC) and those of PSC alone.

Results

PSC was diagnosed in 50 patients in four different tertiary hospitals in Korea. Of them, 18 patients (36.0%) had UC-PSC and 32 patients (64.0%) had PSC alone. The median age at PSC diagnosis was younger in the UC-PSC group than that in the PSC alone group (37 vs. 54 years, P = 0.002). In multivariate analysis, older age at PSC diagnosis (P = 0.007; odds ratio [OR], 0.884; 95% confidence interval [CI], 0.808–0.966) and current smoking habit (P = 0.033; OR, 0.026; 95% CI, 0.001–0.748) were determined to be independent factors for reducing the possibility of developing concomitant UC after PSC. Additionally, UC-PSC was shown to be an independent risk factor for the development of colorectal dysplasia (P = 0.044; OR, 10.829; 95% CI, 1.065–110.127).

Conclusions

Our analysis showed that UC-PSC is more likely to be negatively associated with current smoking and older age at the time of PSC diagnosis. Moreover, UC-PSC increased the risk of colorectal dysplasia.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  1. Lazaridis KN, LaRusso NF (2016) Primary sclerosing cholangitis. N Engl J Med 375(12):1161–1170

    Article  PubMed  PubMed Central  Google Scholar 

  2. Hirschfield GM, Karlsen TH, Lindor KD, Adams DH (2013) Primary sclerosing cholangitis. Lancet 382(9904):1587–1599

    Article  PubMed  Google Scholar 

  3. Palmela C, Peerani F, Castaneda D, Torres J, Itzkowitz SH (2018) Inflammatory bowel disease and primary sclerosing cholangitis: a review of the phenotype and associated specific features. Gut Liver 12(1):17–29

    Article  PubMed  Google Scholar 

  4. Lazaridis KN, LaRusso NF (2016) Primary sclerosing cholangitis. N Engl J Med 375(25):2501–2502

    PubMed  Google Scholar 

  5. Boonstra K, van Erpecum KJ, van Nieuwkerk KM, Drenth JP, Poen AC, Witteman BJ, Tuynman HA, Beuers U, Ponsioen CY (2012) Primary sclerosing cholangitis is associated with a distinct phenotype of inflammatory bowel disease. Inflamm Bowel Dis 18(12):2270–2276

    Article  PubMed  Google Scholar 

  6. Boberg KM, Aadland E, Jahnsen J, Raknerud N, Stiris M, Bell H (1998) Incidence and prevalence of primary biliary cirrhosis, primary sclerosing cholangitis, and autoimmune hepatitis in a Norwegian population. Scand J Gastroenterol 33(1):99–103

    Article  PubMed  CAS  Google Scholar 

  7. Kaplan GG, Laupland KB, Butzner D, Urbanski SJ, Lee SS (2007) The burden of large and small duct primary sclerosing cholangitis in adults and children: a population-based analysis. Am J Gastroenterol 102(5):1042–1049

    Article  PubMed  Google Scholar 

  8. Hashimoto E, Ideta M, Taniai M, Watanabe U, Okuda H, Nagasako K, Hisamitsu T, Obata H (1993) Prevalence of primary sclerosing cholangitis and other liver diseases in Japanese patients with chronic ulcerative colitis. J Gastroenterol Hepatol 8(2):146–149

    Article  PubMed  CAS  Google Scholar 

  9. Ye BD, Yang SK, Boo SJ, Cho YK, Yang DH, Yoon SM, Kim KJ, Byeon JS, Myung SJ, Yu CS, Yun SC, Kim JH (2011) Clinical characteristics of ulcerative colitis associated with primary sclerosing cholangitis in Korea. Inflamm Bowel Dis 17(9):1901–1906

    Article  PubMed  Google Scholar 

  10. Fraga M, Fournier N, Safroneeva E, Pittet V, Godat S, Straumann A, Nydegger A, Vavricka SR, Moradpour D, Schoepfer AM (2017) Primary sclerosing cholangitis in the Swiss Inflammatory Bowel Disease Cohort Study: prevalence, risk factors, and long-term follow-up. Eur J Gastroenterol Hepatol 29(1):91–97

    Article  PubMed  Google Scholar 

  11. Ludwig J, Barham SS, LaRusso NF, Elveback LR, Wiesner RH, McCall JT (1981) Morphologic features of chronic hepatitis associated with primary sclerosing cholangitis and chronic ulcerative colitis. Hepatology 1(6):632–640

    Article  PubMed  CAS  Google Scholar 

  12. Glowacki MK, Zwolinska-Wcislo M, Fraczek P, Gomulska M, Owczarek D, Cibor D, Ciesla A, Mach T (2015) Clinical course of primary sclerosing cholangitis and concomitant ulcerative colitis—a preliminary report of retrospective study among patients from Southern Poland. Folia Med Cracov 55(2):61–68

    PubMed  Google Scholar 

Download references

Funding

This research was supported by a grant (NRF-2017R1A1A1A05001011) from the Basic Science Research Program through the National Research Foundation of Korea, which is funded by the Ministry of Science, ICT and Future Planning.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea

    Yong Eun Park, Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae Il Kim & Won Ho Kim MD

  2. Division of Gastroenterology, Department of Internal Medicine, Inje University School of Medicine, Haeundae Paik Hospital, Busan, Republic of Korea

    Yong Eun Park

  3. Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae Il Kim & Won Ho Kim MD

  4. Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    Jae Jun Park

  5. Department of Gastroenterology, Gachon University, Gil Medical Center, Incheon, Korea

    Yoon Jae Kim

  6. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea

    Chang Hwan Choi

Authors
  1. Yong Eun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Jae Hee Cheon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jae Jun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Yoon Jae Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Chang Hwan Choi
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Yehyun Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Soo Jung Park
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Tae Il Kim
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Won Ho Kim MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

Yong Eun Park: acquisition of data; analysis and interpretation of data; drafting of the manuscript. Jae Jun Park: acquisition of data; study concept and design. Yoon Jae Kim: acquisition of data; study concept and design. Chang Hwan Choi: acquisition of data; study concept and design. Yehyun Park: study concept and design; critical revision of the manuscript for important intellectual content. Soo Jung Park: study concept and design; critical revision of the manuscript for important intellectual content. Tae Il Kim: study concept and design; critical revision of the manuscript for important intellectual content. Won Ho Kim: study concept and design; critical revision of the manuscript for important intellectual content. Jae Hee Cheon: acquisition of data; study concept and design; critical revision of the manuscript for important intellectual content. All authors approved the final version of the article, including the authorship list.

Corresponding author

Correspondence to Jae Hee Cheon.

Ethics declarations

This study was performed in accordance with the ethical guidelines of the 1975 Declaration of Helsinki and approved by the Institutional Review Board of Severance Hospital.

Conflict of interest

The authors declare that they have no conflicts of interest.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Park, Y.E., Cheon, J.H., Park, J.J. et al. Risk factors and clinical courses of concomitant primary sclerosing cholangitis and ulcerative colitis: a Korean multicenter study. Int J Colorectal Dis 33, 1497–1500 (2018). https://doi.org/10.1007/s00384-018-3123-6

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00384-018-3123-6

Keywords

Search

Navigation