Prevalence of inflammatory bowel disease among patients with primary sclerosing cholangitis in Iran

Publication date: Available online 28 March 2016
Source:Arab Journal of Gastroenterology
Author(s): Mohammad Hadizadeh, Seyed H. Abedi, Habib Malekpour, Ebrahim Radinnia, Sayena Jabbehdari, Maryam Padashi, Mohammad R. Zali, Amir H. Mohammad Alizadeh
Background and study aimsIn Iran, the epidemiology of primary sclerosing cholangitis (PSC) and its association with inflammatory bowel disease (IBD) have not been studied thoroughly. This study investigates the epidemiology and prevalence of IBD among patients with PSC.Patients and methodsA retrospective study of 154 patients with PSC was conducted. The demographic and clinical data were collected, and the variables were analysed in the following two patient groups: patients with both PSC and IBD, and patients with PSC and without IBD.ResultsA total of 154 patients with a mean age of 40.3years (range 20–81years) were included, of whom 57 (37%) were female and 97 (63%) male. Ninety-six patients (62.3%) were diagnosed with IBD, 92 (59.7%) with ulcerative colitis, and four (2.6%) with Crohn's disease. In this study, elevated alkaline phosphatase levels were found in 90.8% of patients. The intra-hepatic duct (IHD) and extrahepatic duct (EHD) were involved in 70.5% of patients, isolated intrahepatic bile duct in 24.4%, and isolated extrahepatic duct in 3.8%. Small-duct PSC (normal results of imaging and PSC proved by histology of liver biopsy) was observed only in 1.3% of patients.ConclusionPSC has become increasingly diagnosed in Iran. This is possibly because of better diagnostics and the increasing prevalence of IBD in this country. For diagnosing PSC and identifying the presence of IHD strictures, the results of both magnetic resonance cholangiopancreatography (MRCP) and endoscopic retrograde cholangiopancreatography (ERCP) showed good interobserver agreement, but the ERCP results could be used to evaluate the presence and severity of EHD strictures.



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