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- Title
Extensive Disease Subtypes in Adult Patients with Ulcerative Colitis: Non-pancolitis Versus Pancolitis.
- Authors
Shin, Dong Suk; Cheon, Jae Hee; Park, Yong Eun; Park, Yehyun; Park, Soo Jung; Kim, Tae Il; Kim, Won Ho
- Abstract
<bold>Background and Aim: </bold>Few studies have compared pancolitis and non-pancolitis E3 in adult patients with ulcerative colitis (UC). This study aimed to evaluate the natural disease courses and factors affecting outcomes between pancolitis and non-pancolitis E3.<bold>Methods: </bold>We retrospectively analyzed 117 patients, including 93 with extensive colitis (E3) and 24 with UC confined to the rectum or left-sided colon and appendiceal orifice inflammation at the time of diagnosis, who were regularly followed up for at least 1 year. Patients with E3 were divided into two groups according to the degree of disease extension: pancolitis group (disease extent up to the cecum or proximal ascending colon) and non-pancolitis E3 group (disease extent above the splenic flexure but not up to the proximal ascending colon). Clinical findings at diagnosis; comorbidity; medications; Mayo score; cumulative rates of corticosteroid, immunomodulator, and anti-tumor necrosis factor (anti-TNF) alpha use; relapse; and admission were compared between the pancolitis and non-pancolitis E3 groups.<bold>Results: </bold>The median follow-up duration of the 117 patients was 74 (range 15-158) months. Fifty-one patients (43.5%) had pancolitis. The Mayo score at initial diagnosis, cumulative relapse rate, and cumulative admission rate were significantly higher in the pancolitis group than in the non-pancolitis E3 group (P < 0.001, P = 0.023 and P = 0.007, respectively). However, there was no significant difference between the groups in the rates of cumulative immunomodulator and anti-TNF alpha use (P = 0.67 and P = 0.73, respectively).<bold>Conclusions: </bold>In patients with extensive UC (E3), pancolitis was associated with higher probabilities of cumulative relapse or admission, indicating poor prognosis.
- Subjects
ULCERATIVE colitis; PANCOLITIS; TUMOR necrosis factors; COMORBIDITY; PROGNOSIS; IMMUNOLOGICAL adjuvants; ULCERATIVE colitis diagnosis; COLECTOMY; COMPARATIVE studies; HOSPITAL care; RESEARCH methodology; MEDICAL cooperation; RESEARCH; RESEARCH funding; DISEASE relapse; EVALUATION research; RETROSPECTIVE studies; THERAPEUTICS
- Publication
Digestive Diseases & Sciences, 2018, Vol 63, Issue 11, p3097
- ISSN
0163-2116
- Publication type
journal article
- DOI
10.1007/s10620-018-5218-x