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Active Colitis More Likely in Children in Clinical Remission Who Have PSC and IBD

August 29, 2018 6:55 am

A recent study (A Ricciuto et al. Clin Gastroenterol Hepatol 2018; 16: 1098-1105) provides more data regarding the lack of symptom correlation and inflammatory bowel disease (IBD) activity in children with primary sclerosing cholangitis (PSC).

In a prospective study of children with colonic IBD with and without PSC, the authors followed clinical features (eg. PUCAI), fecal calprotectin and endoscopy severity.

Key findings:

• Patients with PSC-IBD (n=37) in clinical remission had higher endoscopic scores and greater odd of active endoscopic disease than IBD-only controls (n=50) (odds ratio 5.9, with CI 1.6-21.5)
• Fecal calprotectin level <93 mcg/g were identified mucosal healing with 100% sensitivity and 92% specificity when compared with UC Endoscopic Index of Severity (UCEIS)

Overall, this study is in agreement with a prior adult study showing higher levels of active disease in those with PSC-IBD compared to those with IBD alone, despite clinical remission (Why does PSC increase the risk of colorectal cancer in UC?).

My take: Particularly in individuals with the combination of IBD-PSC, objective biomarkers (eg. Calprotectin) are needed to identify the accuracy of clinical remission; though, even in patients with IBD without PSC, objective biomarkers are needed as well due to the limitations of clinical symptom indices.

Related blog posts:

• Big Study of PSC in Children
• PSC -Natural History Study (pediatric)
• Primary Sclerosing Cholangitis (PSC) –Natural History Study
• Why does PSC increase the risk of colorectal cancer in UC?
• Remission in Crohn’s Disease

Moraine Lake, Banff

Posted by gutsandgrowth

Categories: inflammatory bowel disease

Tags: calprotectin, colitis, primary sclerosing cholangitis, Ulcerative colitis

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9 Responses to “Active Colitis More Likely in Children in Clinical Remission Who Have PSC and IBD”

1. […] Active Colitis More Likely in Children with PSC-IBD […]

   By Ursodeoxycholic Acid in Pediatric Primary Sclerosing Cholangitis | gutsandgrowth on June 21, 2019 at 7:08 am

2. […] Active Colitis More Likely in Children with PSC-IBD […]

   By Easy Advice for Pediatric Hepatologists: PSC Surveillance Recommendations | gutsandgrowth on December 8, 2019 at 9:01 am

3. […] Active Colitis More Likely in Children with PSC-IBD […]

   By Development of Primary Sclerosing Cholangitis in Pediatric Patients with Inflammatory Bowel Disease | gutsandgrowth on January 10, 2020 at 7:03 am

4. […] Active Colitis More Likely in Children with PSC-IBD […]

   By Online Aspen Webinar (Part 3) -Primary Sclerosing Cholangitis | gutsandgrowth on August 1, 2020 at 9:01 am

5. […] disease; it is similar to a prospective study by the same group in 2018 (n=37):  (prior blog post: Active Colitis More Likely in Children in Clinical Remission Who Have IBD and PSC) Key finding: Higher proportions of children with PSC-IBD had backwash ileitis, pancolitis, and […]

   By IBD Update -September 2020 | gutsandgrowth on September 9, 2020 at 7:01 am

6. […] Active Colitis More Likely in Children with PSC-IBD […]

   By How Primary Sclerosing Cholangitis Alters Outcomes in Inflammatory Bowel Disease | gutsandgrowth on November 10, 2020 at 7:00 am

7. […] Active Colitis More Likely in Children with PSC-IBD […]

   By Recurrent PSC in Children After Liver Transplantation | gutsandgrowth on November 10, 2021 at 7:00 am

8. […] Active Colitis More Likely in Children in Clinical Remission Who Have PSC and IBD […]

   By Long-Term Outcomes of Pediatric Patients with Sclerosing Cholangitis in the Setting of Inflammatory Bowel Disease | gutsandgrowth on January 21, 2022 at 7:33 am

9. […] Active Colitis More Likely in Children with PSC-IBD […]

   By PSC in IBD | gutsandgrowth on February 12, 2022 at 9:01 am

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