Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India.

Cholangitis, sclerosing Colitis, ulcerative India Inflammatory bowel diseases Prevalence

Journal

Intestinal research
ISSN: 1598-9100
Titre abrégé: Intest Res
Pays: Korea (South)
ID NLM: 101572802

Informations de publication

Date de publication:
Oct 2023
Historique:
received: 09 07 2022
accepted: 19 09 2022
medline: 2 12 2022
pubmed: 2 12 2022
entrez: 1 12 2022
Statut: ppublish

Résumé

Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD. Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated. Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD. Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Sections du résumé

BACKGROUND/AIMS OBJECTIVE
Primary sclerosing cholangitis (PSC) represents the most common hepatobiliary extraintestinal manifestation of inflammatory bowel disease (IBD), including ulcerative colitis (UC) and Crohn's disease (CD). Limited data exist on PSC in patients with IBD from India. We aimed to assess the prevalence and disease spectrum of PSC in Indian patients with IBD.
METHODS METHODS
Database of IBD patients at 5 tertiary care IBD centers in India were analyzed retrospectively. Data were extracted and the prevalence of PSC-IBD was calculated.
RESULTS RESULTS
Forty-eight patients out of 12,216 patients with IBD (9,231 UC, 2,939 CD, and 46 IBD unclassified) were identified to have PSC, resulting in a prevalence of 0.39%. The UC to CD ratio was 7:1. Male sex and pancolitis (UC) or colonic CD were more commonly associated with PSC-IBD. The diagnosis of IBD preceded the diagnosis of PSC in most of the patients. Majority of the patients were symptomatic for liver disease at diagnosis. Eight patients (16.66%) developed cirrhosis, 5 patients (10.41%), all UC, developed malignancies (3 colorectal cancer [6.25%] and 2 cholangiocarcinoma [4.16%]), and 3 patients died (2 decompensated liver disease [4.16%] and 1 cholangiocarcinoma [2.08%]) on follow-up. None of the patients mandated surgical therapy for IBD.
CONCLUSIONS CONCLUSIONS
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.

Identifiants

pubmed: 36453008
pii: ir.2022.00087
doi: 10.5217/ir.2022.00087
pmc: PMC10626019
doi:

Types de publication

Journal Article

Langues

eng

Pagination

452-459

Références

Gastroenterol Rep (Oxf). 2016 Feb;4(1):43-9
pubmed: 25355801
United European Gastroenterol J. 2017 Aug;5(5):708-714
pubmed: 28815035
Gut. 2016 Oct;65(10):1579-81
pubmed: 27402486
Lancet. 2002 Jan 12;359(9301):150-7
pubmed: 11809275
Lancet Gastroenterol Hepatol. 2020 Dec;5(12):1076-1088
pubmed: 33181087
Am J Gastroenterol. 2007 May;102(5):1042-9
pubmed: 17313496
Gastroenterology. 1991 May;100(5 Pt 1):1319-23
pubmed: 2013375
Gut. 2017 Feb;66(2):386-388
pubmed: 27196590
Inflamm Bowel Dis. 2009 Sep;15(9):1331-6
pubmed: 19229982
J Clin Gastroenterol. 2020 Sep;54(8):725-732
pubmed: 31770158
Gut Liver. 2018 Jan 15;12(1):17-29
pubmed: 28376583
J Gastroenterol Hepatol. 2022 Jun;37(6):1004-1015
pubmed: 35178742
Intest Res. 2016 Jul;14(3):264-9
pubmed: 27433149
Gut. 2013 Apr;62(4):531-9
pubmed: 22993202
Lancet. 2014 Jun 21;383(9935):2168-79
pubmed: 24581682
Dis Colon Rectum. 2011 Nov;54(11):1392-7
pubmed: 21979184
Nature. 2012 Nov 1;491(7422):119-24
pubmed: 23128233
Inflamm Bowel Dis. 2013 Apr;19(5):1004-9
pubmed: 23502353
Scand J Gastroenterol. 1997 Feb;32(2):153-61
pubmed: 9051876
Am J Gastroenterol. 2007 Aug;102(8):1677-82
pubmed: 17433022
Indian J Gastroenterol. 2015 Jan;34(1):43-50
pubmed: 25663290
Expert Rev Gastroenterol Hepatol. 2022 Feb;16(2):129-139
pubmed: 35078376
Gastroenterology. 2021 Dec;161(6):1865-1877
pubmed: 34425093
World J Gastroenterol. 2015 Mar 28;21(12):3644-9
pubmed: 25834332
Gut. 2019 Aug;68(8):1356-1378
pubmed: 31154395
Mutat Res. 1990 May;238(3):313-20
pubmed: 2188127
Stem Cell Res Ther. 2016 Dec 1;7(1):181
pubmed: 27908290
Gastroenterology. 2021 Apr;160(5):1584-1598
pubmed: 33385426
United European Gastroenterol J. 2018 May;6(4):500-508
pubmed: 29881604
Gut. 1997 Oct;41(4):522-5
pubmed: 9391253
Scand J Gastroenterol. 1991 Jan;26(1):97-102
pubmed: 2006402
J Crohns Colitis. 2014 Sep;8(9):956-63
pubmed: 24559536
Am J Surg. 1965 Aug;110:239-46
pubmed: 14313190
J Crohns Colitis. 2019 Feb 1;13(2):144-164
pubmed: 30137275
Science. 2019 Jun 21;364(6446):1133-1135
pubmed: 31221845
J Crohns Colitis. 2012 Mar;6(2):174-81
pubmed: 22325171
J Hepatol. 2008;48 Suppl 1:S38-57
pubmed: 18304683
World J Gastroenterol. 2015 Feb 14;21(6):1956-71
pubmed: 25684965
Gut. 2005 Jan;54(1):91-6
pubmed: 15591511
J Crohns Colitis. 2019 Dec 10;13(12):1492-1500
pubmed: 31063540
Gastroenterology. 2016 Oct;151(4):660-669.e4
pubmed: 27342213
N Engl J Med. 2016 Sep 22;375(12):1161-70
pubmed: 27653566
Digestion. 2014;90(2):122-9
pubmed: 25277851

Auteurs

Arshdeep Singh (A)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Vandana Midha (V)

Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India.

Vikram Narang (V)

Department of Pathology, Dayanand Medical College and Hospital, Ludhiana, India.

Saurabh Kedia (S)

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Ramit Mahajan (R)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Pavan Dhoble (P)

P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, India.

Bhavjeet Kaur Kahlon (BK)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Ashvin Singh Dhaliwal (AS)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Ashish Tripathi (A)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Shivam Kalra (S)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Narender Pal Jain (NP)

Department of Internal Medicine, Dayanand Medical College and Hospital, Ludhiana, India.

Namita Bansal (N)

Research and Development Centre, Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Rupa Banerjee (R)

Asian Institute of Gastroenterology, Hyderabad, India.

Devendra Desai (D)

P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, India.

Usha Dutta (U)

Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Vineet Ahuja (V)

Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi, India.

Ajit Sood (A)

Department of Gastroenterology, Dayanand Medical College and Hospital, Ludhiana, India.

Classifications MeSH