1.Low prevalence of primary sclerosing cholangitis in patients with inflammatory bowel disease in India
Arshdeep SINGH ; Vandana MIDHA ; Vikram NARANG ; Saurabh KEDIA ; Ramit MAHAJAN ; Pavan DHOBLE ; Bhavjeet Kaur KAHLON ; Ashvin Singh DHALIWAL ; Ashish TRIPATHI ; Shivam KALRA ; Narender Pal JAIN ; Namita BANSAL ; Rupa BANERJEE ; Devendra DESAI ; Usha DUTTA ; Vineet AHUJA ; Ajit SOOD
Intestinal Research 2023;21(4):452-459
Background/Aims:
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:
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:
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
Concomitant PSC in patients with IBD is uncommon in India and is associated with lower rates of development of malignancies.
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