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Ulcerative colitis and persistent liver dysfunction.

H A Shepherd, W S Selby, R W Chapman

The Quarterly Journal of Medicine

|January 1, 1983

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Primary sclerosing cholangitis is often present in ulcerative colitis patients with abnormal liver tests. Cholangiography is essential for diagnosis, alongside liver biopsy, to confirm this condition.

Area of Science:

Gastroenterology and Hepatology
Immunology

Background:

Ulcerative colitis (UC) is an inflammatory bowel disease.
Abnormal liver function tests can occur in UC patients.
Primary sclerosing cholangitis (PSC) is a chronic liver disease.

Purpose of the Study:

To investigate the prevalence of PSC in UC patients with abnormal liver function tests.
To evaluate diagnostic methods for PSC in this population.
To explore associations between PSC and specific histocompatibility antigens.

Main Methods:

Screening of 681 UC outpatients for abnormal liver function tests.
Cholangiography and liver biopsy for diagnosis of PSC.
Analysis of histocompatibility antigens (HLA B8 and DR3).

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Main Results:

3.0% of UC patients had abnormal liver function tests.
17 patients (2.4%) were diagnosed with PSC via cholangiography.
Liver biopsies were diagnostic in only 50% of PSC cases.
81% of patients with abnormal liver tests had PSC.
A significant association was found with HLA B8 and DR3.

Conclusions:

Persistently abnormal liver function tests in UC patients strongly suggest PSC.
Cholangiography is crucial for reliable PSC diagnosis in UC patients, complementing liver biopsy.
Specific histocompatibility antigens (HLA B8, DR3) are associated with PSC in UC.