Colorectal Dysplasia and Cancer in Pediatric-Onset Ulcerative Colitis Associated With Primary Sclerosing Cholangitis

El‐Matary, Wael; Guthery, Stephen L.; Amir, Achiya; DiGuglielmo, Matthew; Draijer, Laura G.; Furuya, Katryn N.; Gupta, Nitika; Hochberg, Jessica T.; Horslen, Simon; Kerkar, Nanda; Koot, Bart; Laborda, Trevor J.; Loomes, Kathleen M.; Mack, Cara L.; Martínez, Mercedes; Miethke, Alexander; Miloh, Tamir; Mogul, Douglas; Mohammed, Saeed; Moroz, Stacy; Ovchinsky, Nadia; Perito, Emily R.; Rao, Girish S.; Ricciuto, Amanda; Sathya, P; Schwarz, Kathleen B.; Shah, Uzma; Singh, Ruchi; Soufi, Nisreen; Valentino, Pamela L.; Zizzo, Andréanne N.; Deneau, Mark

doi:10.1016/j.cgh.2020.04.055

Cited by 11 publications

(16 citation statements)

References 8 publications

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“…It is often asymptomatic despite significant endoscopic and histologic activity 143,144. In children, 5% of patients with PSC without a prior diagnosis of IBD and no symptoms were found to have quiescent colitis 145. In addition, histological evidence of IBD without endoscopic changes of IBD is frequent 146.…”

Section: Diagnosis Of Pscmentioning

confidence: 99%

“…[33,145,199] Children with PSC and IBD onset before age 6 had a greater risk of CRC than those diagnosed in their teenage years. [145] Chronic inflammation may contribute to the CRC risk and is often underestimated in PSC, in both adults and children. [144,199] The risk of CRC in patients with PSC without IBD relative to the average-risk population is unknown, but in one study of 590 patients with PSC, 20 developed CRC and all but one had IBD.…”

Section: Crcmentioning

confidence: 99%

“…Young age at IBD diagnosis is a risk factor for CRC in PSC‐IBD 33,145,199. Children with PSC and IBD onset before age 6 had a greater risk of CRC than those diagnosed in their teenage years 145.…”

Section: Natural History Of Pscmentioning

confidence: 99%

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AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma

et al. 2022

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Inclusion of guidance for the diagnosis and management of cholangiocarcinoma (CCA) in patients with and without primary sclerosing cholangitis (PSC) (Figures 5, 8, and 9). Introduction of the term relevant stricture, defined as any biliary stricture of the common hepatic duct or hepatic ducts associated with signs or symptoms of obstructive cholestasis and/or bacterial cholangitis (Table 1). In patients with equivocal MRI with cholangiopancreatography (MRI/MRCP) findings, a repeated high-quality MRI/ MRCP should be performed for diagnostic purposes. Endoscopic retrograde cholangiopancreatography (ERCP) should be avoided for the diagnosis of PSC (Figure 2).

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Section: Diagnosis Of Pscmentioning

confidence: 99%

Section: Crcmentioning

confidence: 99%

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AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma

et al. 2022

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“…The longer duration of inflammation may explain this finding. However, very-early-onset IBD could be an independent risk factor for developing CRC/dysplasia (20).…”

Section: Disease-related Cancer Riskmentioning

confidence: 99%

“…Several medications are currently used to control inflammation in patients with IBD. Immunomodulators such as thiopurines (for example azathioprine (AZA) and 6-mercaptopurine) and methotrexate (MTX) or biological medications such as anti-TNF agents, are commonly used in children with IBD, but have been associated with concerns regarding cancer risk (19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31)(32)(33)(34)(35).…”

Section: Medication-related Cancer Riskmentioning

confidence: 99%

Cancer Risk in Pediatric-Onset Inflammatory Bowel Disease

El‐Matary

Bernstein

2020

Front. Pediatr.

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Inflammatory bowel disease (IBD) is a chronic, immune-mediated, non-curable disease. The incidence of IBD appears to have risen over the last few decades especially in the pediatric age group. IBD usually presents with gastrointestinal symptoms, including abdominal pain, diarrhea, and bleeding per rectum but can also be associated with systemic symptoms such as weight loss, fatigue, joint and skin problems, and psychological comorbidities. One major complication is gastrointestinal and extra-intestinal malignancy. This review discusses literature that focuses on cancer risk of pediatric-onset IBD.

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