Hepatobiliary Dysfunction and Primary Sclerosing Cholangitis in Patients with Crohn's Disease

Abstract

The results of our study indicate that PSC is the major hepatic disease in patients with CD and long-standing abnormal liver function tests and is approximately as prevalent as in ulcerative colitis. Patients with PSC and CD may have a milder liver disease than patients with PSC and ulcerative colitis, perhaps because large-duct PSC is less common in patients with CD. Cholangiograms and liver biopsies are both needed to evaluate the extent of the disease.

Primary sclerosing cholangitis: Summary of a workshop

“…38 In Western countries, 2.4% to 4% of patients with IBD have PSC. [39][40][41] Of course, the frequency of these associations depends on diagnostic rigor. Thus, in some studies, patients with IBD are routinely evaluated for liver disease (serum enzymes) or biliary abnormalities [ERCP or magnetic resonance cholangiopancreatography (MRCP)].…”

Extraintestinal Manifestations of Ulcerative Colitis

“…Pericholangitis (or small-duct PSC) is now referred to patients with biochemical and histologic characteristics of PSC, but with normal appearing cholangiograms (Wee & Ludwig, 1985). Small-duct PSC is more often associated with Crohn's disease whereas largeduct PSC (classical PSC) is more often associated with UC (Bjornsson et al, 2008;Loftus, 1997;Rasmussen et al, 1997). Compared to large-duct PSC, small-duct PSC has a relatively favorable prognosis with longer transplant-free survival.…”

Inflammatory Bowel Disease and Primary Sclerosing Cholangitis

“…The prevalence of PSC in patients with Crohn's disease varies between 1.4-3.4% (Rasmussen et al, 1997;Schrumpf et al, 1980;Shepherd et al, 1983). Colitis in PSC is often quiescent or mild.…”

“…The association of PSC and Crohn's disease, which was first described by Atkinson andCarroll in 1964 (Atkinson &Carroll, 1964) , is relatively rare. The incidence of CD in PSC varies between 1.3-14% (Wiesner & LaRusso, 1980;Chapman et al, 1980;Rasmussen et al, 1997;McGarity et al, 1991;Faubion et al, 2001;Loftus et al, 2005;Tobias et al, 1983). The most eminent finding is rectal sparing.…”