The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan
Background: Primary sclerosing cholangitis (PSC) is often associated with ulcerative colitis (UC). We investigated the clinical characteristics of pediatric UC patients with and without PSC. Methods: We retrospectively recruited children with UC, with and without PSC, from 2006 to 2017 in a tertiary...
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Elsevier
2021-09-01
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| Series: | Pediatrics and Neonatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1875957221000802 |
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| author | Mu-Ming Chien Mei-Hwei Chang Kai-Chi Chang Yu-Chun Chiu Huey-Ling Chen Hong-Yuan Hsu Jia-Feng Wu |
| author_facet | Mu-Ming Chien Mei-Hwei Chang Kai-Chi Chang Yu-Chun Chiu Huey-Ling Chen Hong-Yuan Hsu Jia-Feng Wu |
| author_sort | Mu-Ming Chien |
| collection | DOAJ |
| description | Background: Primary sclerosing cholangitis (PSC) is often associated with ulcerative colitis (UC). We investigated the clinical characteristics of pediatric UC patients with and without PSC. Methods: We retrospectively recruited children with UC, with and without PSC, from 2006 to 2017 in a tertiary center in Taiwan. The clinical data of the patients, including clinical and endoscopic UC severity scores, medications, and laboratory parameters, were analyzed. Results: We recruited five children with PSC-UC (PSC-UC group), and 26 with UC alone (non-PSC UC group) in this retrospective analysis. Among the patients with PSC-UC, four (80%) were compatible with definite or probable autoimmune sclerosing cholangitis (ASC). The UC Endoscopic Index of Severity (5.00 vs. 9.00, P = 0.003) and Mayo score (4.00 vs. 8.00, P = 0.014) were significantly lower in the PSC-UC group than the non-PSC UC group. The prevalence of immunomodulator use was significantly higher in the PSC-UC than the non-PSC UC group (100% vs. 42.3%, P = 0.043), but there was no difference regarding steroids, mesalamine, or biologics. At the end of the study, significantly fewer patients were steroid-free in the PSC-UC than the non-PSC UC group (20.0% vs. 84.6%, P = 0.010). Conclusions: Pediatric patients with PSC-UC had less severe colitis than those with UC alone in terms of the clinical activity index and endoscopic severity index, but they were more likely to need an immunomodulator and less likely to be steroid-free in the long term, for the control of liver disease. |
| format | Article |
| id | doaj-art-fac5f3edda044bc1b605676e2a1d57bc |
| institution | OA Journals |
| issn | 1875-9572 |
| language | English |
| publishDate | 2021-09-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Pediatrics and Neonatology |
| spelling | doaj-art-fac5f3edda044bc1b605676e2a1d57bc2025-08-20T02:28:10ZengElsevierPediatrics and Neonatology1875-95722021-09-0162548349010.1016/j.pedneo.2021.05.001The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in TaiwanMu-Ming Chien0Mei-Hwei Chang1Kai-Chi Chang2Yu-Chun Chiu3Huey-Ling Chen4Hong-Yuan Hsu5Jia-Feng Wu6Department of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, Taiwan; Department of Pediatrics, Taipei Medical University Hospital, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, Taiwan; Hepatitis Research Center, National Taiwan University Hospital, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, National Taiwan University, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, Taiwan; Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, Taiwan; Department of Medical Education and Bioethics, National Taiwan University College of Medicine, Taipei, TaiwanDepartment of Pediatrics, National Taiwan University Children's Hospital, National Taiwan University, Taipei, Taiwan; Corresponding author. Department of Pediatrics, National Taiwan University Hospital, No. 8, Chung-Shan S. Rd., Taipei, Taiwan.Background: Primary sclerosing cholangitis (PSC) is often associated with ulcerative colitis (UC). We investigated the clinical characteristics of pediatric UC patients with and without PSC. Methods: We retrospectively recruited children with UC, with and without PSC, from 2006 to 2017 in a tertiary center in Taiwan. The clinical data of the patients, including clinical and endoscopic UC severity scores, medications, and laboratory parameters, were analyzed. Results: We recruited five children with PSC-UC (PSC-UC group), and 26 with UC alone (non-PSC UC group) in this retrospective analysis. Among the patients with PSC-UC, four (80%) were compatible with definite or probable autoimmune sclerosing cholangitis (ASC). The UC Endoscopic Index of Severity (5.00 vs. 9.00, P = 0.003) and Mayo score (4.00 vs. 8.00, P = 0.014) were significantly lower in the PSC-UC group than the non-PSC UC group. The prevalence of immunomodulator use was significantly higher in the PSC-UC than the non-PSC UC group (100% vs. 42.3%, P = 0.043), but there was no difference regarding steroids, mesalamine, or biologics. At the end of the study, significantly fewer patients were steroid-free in the PSC-UC than the non-PSC UC group (20.0% vs. 84.6%, P = 0.010). Conclusions: Pediatric patients with PSC-UC had less severe colitis than those with UC alone in terms of the clinical activity index and endoscopic severity index, but they were more likely to need an immunomodulator and less likely to be steroid-free in the long term, for the control of liver disease.http://www.sciencedirect.com/science/article/pii/S1875957221000802Autoimmune liver diseasePediatricPrimary sclerosingcholangitisUlcerative colitis |
| spellingShingle | Mu-Ming Chien Mei-Hwei Chang Kai-Chi Chang Yu-Chun Chiu Huey-Ling Chen Hong-Yuan Hsu Jia-Feng Wu The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan Pediatrics and Neonatology Autoimmune liver disease Pediatric Primary sclerosingcholangitis Ulcerative colitis |
| title | The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan |
| title_full | The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan |
| title_fullStr | The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan |
| title_full_unstemmed | The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan |
| title_short | The characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis: A single-center study in Taiwan |
| title_sort | characteristics of pediatric ulcerative colitis with primary sclerosing cholangitis a single center study in taiwan |
| topic | Autoimmune liver disease Pediatric Primary sclerosingcholangitis Ulcerative colitis |
| url | http://www.sciencedirect.com/science/article/pii/S1875957221000802 |
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