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Appearance of hepatobiliary diseases in a population‐based cohort with inflammatory bowel diseases ( I nflammatory B owel D isease C ohort of the U ppsala R egion)
Author(s) -
Rönnblom Anders,
Holmström Tommy,
Tanghöj Hans,
Rorsman Fredrik,
Sjöberg Daniel
Publication year - 2015
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12947
Subject(s) - medicine , inflammatory bowel diseases , inflammatory bowel disease , population , disease , environmental health
Background and Aim To prospectively follow the evolution of hepatobiliary diseases in a population‐based cohort of patients with inflammatory bowel diseases. Methods Between 2005 and 2009, 790 incident cases of ulcerative colitis and C rohn's disease were registered in the Uppsala Health Region, corresponding to an average incidence of 20.0 and 9.9 new cases/100 000 inhabitants/year, respectively. Liver function tests were analyzed in 97.1% and the results of ensuing investigations were summarized. Results Seventeen patients with primary sclerosing cholangitis were diagnosed corresponding to an overall prevalence of 2.2% (ulcerative colitis 1.7% and C rohn's disease 3.0%, respectively). The median age at diagnosis was 25 years (interquartile range: 17.0–34.0). Among the 92 patients below 17 years of age, three had autoimmune hepatitis and three primary sclerosing cholangitis, summing up to a prevalence of 6.5% immune‐mediated hepatobiliary diseases among the pediatric patients. Three patients have undergone liver transplantation and one died of colonic carcinoma. Ten patients have demonstrated persistent elevation of alkaline phosphatases but had a normal magnetic resonance cholangiopancreatography (two patients) or refused further investigation (one patient). Conclusion In this first large prospective population‐based cohort of 526 patients with ulcerative colitis ( UC ) and 264 with C rohn's disease, 17 cases of primary sclerosing cholangitis were found, among whom three (17%) so far have been liver transplanted and one has died of colon carcinoma. The average age of those affected by primary sclerosing cholangitis is considerably lower than usually reported. Ten patients had or have had elevated alkaline phosphatase without confirmed liver or biliary disease.