У 10% пациентов с впервые диагностированным воспалительным заболеванием кишечника выявлены признаки радиологического первичного склерозирующего холангита

TOPLINE Radiological primary sclerosing cholangitis (PSC) or PSC-like lesions were detected in nearly 1 in 10 patients with newly diagnosed inflammatory bowel disease (IBD) in a prospective Danish cohort study. Nearly half of those with PSC had normal liver biochemistry at diagnosis. METHODOLOGY Researchers conducted a prospective population-based inception cohort study of adults with newly diagnosed ulcerative colitis (UC) or Crohn's disease (CD) in Denmark between 2021 and 2023. Of 527 eligible patients, 389 (242 with UC and 147 with CD) underwent magnetic resonance cholangiopancreatography (MRCP). The median age of the participants was 38 years and 49.4% were women; the median follow-up duration was 2 years. The primary outcome was the prevalence of radiological PSC and nondiagnostic PSC-like lesions at the time of IBD diagnosis. TAKEAWAY Radiological PSC was diagnosed in 31 of 389 patients (8%), including 6.6% with UC and 10.2% with CD, and an additional 1.8% of patients had nondiagnostic PSC-like lesions, yielding a combined prevalence of 9.8%. Only 51.6% of patients with radiological PSC had abnormal liver biochemistry, and 41.9% had elevated levels of alkaline phosphatase at diagnosis. Radiological PSC was more common in patients with extensive colitis (12.3% vs 4.3%; P =.02) and was associated with higher rates of IBD-related hospitalization (41.9% vs 24.4%; P =.03) and biologic therapy (38.7% vs 21.4%; P =.03). Of 20 patients initially classified as having PSC-like lesions, 65% progressed to radiological PSC on repeat MRCP at 1 year; 2 lesions resolved and 5 persisted. IN PRACTICE "This study highlights that MRCP may represent a potential diagnostic tool at IBD onset to improve early detection and disease management in PSC-IBD. However, long-term clinical implications remain uncertain, and prospective follow-up and cost-benefit analyses are required before MRCP can be recommended for routine screening at IBD diagnosis," the authors of the study wrote. SOURCE The study was led by Mohamed Attauabi, MD, PhD, Department of Gastroenterology and Hepatology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark. It was published online on September 1 in Clinical Gastroenterology and Hepatology. LIMITATIONS The study was limited by short follow-up, low number of events, misclassification bias, and the absence of a control group without IBD. DISCLOSURES This study was funded by the Novo Nordisk Foundation. One author reported receiving support from the EU Horizon Europe Program. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.