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PSC common in patients with long-term IBD

Magnetic resonance cholangiography analysis showed presence of lesions associated with primary sclerosing cholangitis, indicating this liver disease was common in patients with long-term inflammatory bowel disease, according to results of a population-based study.

Aida Kapic Lunder, MD, a PhD student and resident at the department of radiology, Akershus University Hospital and Oslo University, Norway, and colleagues conducted a follow-up analysis of a population-based cohort of 756 patients in Southeastern Norway diagnosed with IBD between January 1990 and December 1993. Of these patients, 470 attended a follow-up evaluation 20 years later and were then offered routine clinical blood testing and ileocolonoscopy, where 322 were screened by magnetic resonance cholangiography (MRC). Of these patients, 222 had ulcerative colitis and 100 had Crohn’s disease.

Aida Kapic Lunder

“The aim of [our] study was to estimate the frequency and distribution of MRC lesions including PSC in IBD patients two decades after the initial diagnosis and to identify clinical characteristics associated with these findings,” the researchers wrote.

During the MRC, 7.4% of patients tested positive for PSC-like lesions (n = 24); only 2.2% of these were known to have PSC (n = 7) — the final prevalence of PSC was 8.1% in this cohort. The prevalence of PSC-like lesions varied by IBD — 9% in the Crohn’s disease group and 6.8% in UC group.

Extensive colitis (P = .029), high prevalence of colectomy (P = .002) and chronic/continuous symptoms of IBD (P = .012) were observed more in patients with suspected PSC compared with patients without PSC.

“Sixty-five percent of patients had subclinical PSC associated with progressive IBD, with no biochemical abnormalities and mild disease, based on radiology findings,” the researchers wrote.

Among patients with subclinical features of PSC, the MRC progression score for PSC increased during reexamination after a median 3.2 years (P = .046). The second MRC of patients with PSC-like lesions (n = 17) confirmed the cholangiographic findings, the researchers noted.

“We found the prevalence of PSC to be almost fourfold higher than that detected based on symptoms,” the researchers concluded. “PSC appears to progress in patients with subclinical disease, but long-term outcomes are not known.” – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.