Clinicopathologic features of the syndrome of primary sclerosing cholangitis

Wiesner, Russell H.; LaRusso, Nicholas F.

doi:10.1016/0016-5085(80)90131-6

Cited by 517 publications

(202 citation statements)

References 14 publications

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“…The relationship between pericholangitis and primary sclerosing cholangitis is uncertain. Some studies have suggested that pericholangitis may be a part of the spectrum of sclerosing cholangitis, and the histological manifestations of sclerosing cholangitis and pericholangitis on liver biopsy may be indistinguishable [297]. Patients diagnosed on liver biopsy as having pericholangitis may need to undergo endoscopic retrograde cholangiopancreatography (ERCP) to rule out sclerosing cholangitis.…”

Section: Hepatobiliary Complicationsmentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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In the US, H. pylori vacA shows allelic variation in the signal sequence (which may be type sla, slb or s2) and the mid-region (type ml or m2). Previous PCR-based vacA mid-region typing classified most, but not all, Asian and South American strains tested as ml or m2. We now sought to investigate vacA mid-region diversity further.MotlmodL We studied 13 Japanese, 6 Chinese, 9 Thai, and 8 Peruvian H. pylori isolates. cagA was identified by colony hybridisation (CH), vacA signal sequence was typed by PCR, and vacA mid-region was typed proximally by CH and distally by PCR. Sections of the vacA mid-region from 8 strains were PCR-amplified, sequenced, and compared with known sequences from 8 other strains.Rcuts Of the 36 Asian and South American strains studied, 35 were cagA+ (the cagA-was Peruvian) and 35 were vacA sla (1 cagA + Peruvian was slb). vacA mid-regions from the 13 Japanese strains were not PCR-amplified by ml or m2-specific primers, but hybridised weakly with an ml probe. Sequence analysis of vacA from 1 Japanese strain revealed 91% nucleotide identity with the ml probe but only 71% identity with the m2 probe. The previously equivocal Thai and Peruvian strains also had ml-like mid-region sequences. A Chinese strain was ml in the proximal mid-region and m2 distally, showing a clear crossover site. Final mid-region types were: Japanese, all 13 ml; Chinese, 1 ml, 1 ml/m2, 4 m2; Thai, 3 ml, 6 m2; Peruvian 4 ml, 4 m2. Distal mid-region sequences of 16 strains, compared over 294 bp, clustered into 2 groups, ml and m2. Nucleotide identity between ml and m2 strains ranged from 73-78%. Within groups, m2 strains were less diverse than ml strains (m2 range 94-99.7%, ml 88-99.3%, p<0.001). Sequence analysis of 7 ml and 3 m2 strains over 1.1kb proximally showed maintenance of clustering outside the 294bp region C duions These Asian and South American strains are similar in terms of cagA status and vacA sla genotype, but fall into 2 vacA midregion groups. ml sequences are more diverse than m2, and thus may be phylogenetically older. The vacA sequence of 1 Chinese strain suggests recombination in vivo between ml and m2 alleles. Introduction: H.pylori antimicrobial susceptibility is an important determinant ofthe efficacy of eradication therapies'. The prevalence of antimicrobial resistance varies within the UK and may increase given the increased use of eradication therapy. This multicentre study assesses the prevalence and possible associations ofH.pylon antimicrobial resistance. Methods: H.pylon was isolated from antral biopsies of patients undergoing routine endoscopy and cultured according to standard microbiological methods. Antimicrobial resistance was determined using "E-tests" or disc tests (tinidazole only) with breakpoints defined by previous studies. Results: H.pyloni was isolated from 32% (1222/3823) of patients and antimicrobial susceptibility determined in 90% (1077/1222) Previous case-control studies of IBD have used hospital or community derived controls. There are obvious inherent biases in both metho...

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Section: Hepatobiliary Complicationsmentioning

confidence: 99%

Inflammatory Bowel Disease

Stenson

Hanauer

Cohen

2008

Textbook of Gastroenterology

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“…Typically, liver biopsy reveals only a paucity of normal bile ducts with nonspecific fibrosis and infl ammation of the portal tracts [5,11,29]. The classic onion-skin lesions ( Fig.…”

Section: Diseases Of the Gallbladder And Bile Ducts: Diagnosis And Trmentioning

confidence: 99%

“…These will often return to near normal when the episode of fever, chills, or right upper quadrant pain has resolved. Serum antinuclear, antismooth muscle, and antimitochondrial antibodies are negative in over 90% of patients [11,52]. One exception may be an uncommon variant of PSC termed "small duct PSC" (where cholangiography is normal), in which there may be an overlap with autoimmune hepatitis [113,114].…”

Section: Laboratory Evaluationsmentioning

confidence: 99%

“…With the advent improved imaging techniques, particularly endoscopic retrograde cholangiography (ERC) in 1974, the numbers of cases diagnosed in most major centers increased. Subsequent reviews from the Mayo Clinic and Royal Free Hospital in London spurred further interest in the disease as it was quickly realized that the disorder had an association with infl ammatory bowel disease (IBD), more often affecting young males with ulcerative colitis [4,11].…”

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Primary Sclerosing Cholangitis

Enns¹

2006

Diseases of the Gallbladder and Bile Ducts

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“…Until 1981, 264 cases have been reported in the literature . The majority of those cases were reported in the past decade and possibly reflect the result of increased use of ERCP (endoscopic retrograde cholangiopancreatography) and skinny needle percutaneous transhepatic cholangiography [19,21].…”

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confidence: 99%

Sclerosing cholangitis: Broad spectrum of radiographic features

Chen¹,

Goldberg

1984

Gastrointest Radiol

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The broad spectrum of radiographic appearance of sclerosing cholangitis is illustrated in 19 cases. A classification of intrahepatic and extrahepatic features is presented, based on extent of narrowing of bile ducts, severity of narrowing, contour abnormalities, and presence of postsclerotic dilatation. In 13 of 19 cases, both intra- and extrahepatic ducts were involved. The most common form of intrahepatic involvement (8/19) was irregular stenosis obliterating peripheral ducts leaving only the more central ducts filled with contrast material. The most common type of extrahepatic duct involvement was a well-defined segment of either smooth or irregular narrowing. The most extensive involvement of intrahepatic ducts was often associated with more well-defined, less extensive extrahepatic duct involvement. In 7 patients, radiographic features were evaluated over periods ranging from several months to several years. Intrahepatic duct involvement either remained unchanged or worsened, while extrahepatic features more often remained unchanged. Our classification of patterns of involvement was applied to previous reports and revealed frequency of type of duct involvement similar to our series.

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Clinicopathologic features of the syndrome of primary sclerosing cholangitis

Cited by 517 publications

References 14 publications

Inflammatory Bowel Disease

Inflammatory Bowel Disease

Primary Sclerosing Cholangitis

Sclerosing cholangitis: Broad spectrum of radiographic features

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