Primary sclerosing cholangitis: Characterization of a cohort in a university hospital
DOI:
https://doi.org/10.59093/27112330.146Keywords:
primary sclerosing cholangitis, complications, liver transplantation, mortality, cholestatic liver disease.Abstract
Introduction. Primary sclerosing cholangitis (PSC) is a chronic and progressive cholestatic liver disease for which there is no curative treatment. This study describes the clinical characteristics, complications, and outcomes of the disease in a tertiary care center in Medellín, Colombia. Methods. Medical records were retrospectively reviewed, and demographic information and clinical characteristics of patients with PSC were collected, as well as outcomes such as complications, survival, and liver transplantation. Results. Fifty patients were included; among them, some had features of autoimmune hepatitis (AIH) and overlap with primary biliary cholangitis (PBC). Forty percent were men (20/50), with a median age of 47.5 years (IQR 38–62). Eighty two percent (41/50) were symptomatic, with abdominal pain being the most common manifestation. All patients underwent magnetic resonance cholangiopancreatography (MRCP) at diagnosis, and 18% (9/50) underwent endoscopic retrograde cholangiopancreatography (ERCP). 48% (24/50) had inflammatory bowel disease (IBD), and 75% (18/24) had ulcerative colitis (UC). The most common phenotype was large-duct PSC (38/50). Overall survival at 12, 36, and 60 months was 96.8%, 95%, and 86.9%, respectively. Mortality was 16%, and 26% received liver transplantation. The mean time to transplantation was 4.9 ± 3.7 years, and the mean follow-up was 5.9 ± 4.13 years. Conclusion. In our series, we found a predominance of females, with a lower incidence of IBD than in the Caucasian population. Overall and liver transplant-free survival are good. Few neoplastic complications have been documented.
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