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The Association Between Primary Sclerosing Cholangitis and Microscopic Colitis: A Systematic Review
Hasan Al-Obaidi1, Mustafa Al-Obaidi2, Pratiksha Moliya3
1Internal Medicine, Jamaica Hospital Medical Center, New York, USA.
Cureus
|January 13, 2025
Summary
Primary sclerosing cholangitis (PSC) and microscopic colitis (MC) share links, with MC often diagnosed after PSC. Increased vigilance for MC in PSC patients is crucial for early detection and management.
Area of Science:
- Gastroenterology
- Immunology
- Genetics
Background:
- Limited studies suggest a link between primary sclerosing cholangitis (PSC) and microscopic colitis (MC).
- Potential shared pathophysiological mechanisms warrant further investigation.
- Understanding this association is vital for patient management.
Purpose of the Study:
- To systematically review and analyze existing literature on the association between PSC and MC.
- To identify shared risk factors and clinical implications.
- To inform clinical practice and future research directions.
Main Methods:
- Comprehensive literature search of PubMed, Embase, and Cochrane Library.
- Inclusion of two studies: one case series (12 patients) and one case report (1 patient).
- Analysis of diagnostic timing, clinical presentation, and proposed mechanisms.
Main Results:
- Microscopic colitis diagnoses occurred after primary sclerosing cholangitis in 75% of cases within the case series.
- Many microscopic colitis cases were asymptomatic, suggesting potential underdiagnosis.
- Shared mechanisms include immune dysregulation, genetic predisposition (e.g., HLA-DR3), and gut microbiota alterations.
Conclusions:
- A significant association exists between primary sclerosing cholangitis and microscopic colitis.
- Increased clinical vigilance for microscopic colitis in PSC patients is recommended.
- Further research is needed to validate findings and explore screening and therapeutic strategies.
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