COMMENTARY
See article on page 639
The colon and PSC: new liver, new danger?
| The first 150 words of the full text of this article appear below. |
The close relation between primary sclerosing cholangitis (PSC)
and inflammatory bowel disease (IBD) continues to provide more
questions than answers. The prevalence of IBD in patients with PSC is
about 55-75%, and PSC occurs in patients with ulcerative colitis at a
frequency of 2.5-7.5%.1 2
PSC is found less often in
Crohn's disease where it is usually associated with colonic involvement. Recent studies have found an increased prevalence of
colonic dysplasia and cancer in patients with PSC and ulcerative colitis compared with ulcerative colitis alone.3 4
The
mechanism by which PSC increases the risk of colonic neoplasia is
unknown. The increased long term survival of patients with both PSC and ulcerative colitis after liver transplantation may therefore put these
patients at an increased risk of developing colorectal cancer in view
of the increased neoplastic potential as a result of the immunosuppressive therapy required after liver transplantation. Indeed,
some studies have suggested that
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- Ulcerative colitis has an aggressive course after orthotopic liver transplantation for primary sclerosing cholangitis
- G V Papatheodoridis, M Hamilton, P K Mistry, B Davidson, K Rolles, and A K Burroughs
Gut 1998 43: 639-644.[Abstract] [Full Text] [PDF]
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