Clinical Course of Ulcerative Colitis in Patients with and without Primary Sclerosing Cholangitis

Abstract

Introduction and Aims: We noticed in our practice that the 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 there is any difference between UC activity and its course in patients with and without PSC.

Materials and Methods: 19 patients with UC and PSC (8 male, mean age 25) were enrolled. To every patient with UC and PSC, 3 patients with UC alone (totally 57 patients, 28 male, mean age 24) 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 sulfasalazine or aminosalicylates. Number of hospitalizations and courses of steroid therapy because of UC activity decreased significantly over time (p‹.000) in both groups and it was significantly higher in controls than in cases (p=.045 and .032, respectively).

Conclusions: Development of PSC in patients with UC might have a positive effect on the colonic disease. Further investigation to evaluate basis of this improvement are warranted.