Publicação
Doença inflamatória intestinal associada a colangite esclerosante primária : um fenótipo raro
| Resumo: | Inflammatory Bowel Disease associated with Primary Sclerosing Cholangitis is a rare phenotype, which is more common in men, non-smokers and has a bimodal age distribution. Genetic, immunological and infectious factors has been implicated in the ethiopathogenesis.Phenotypically it has unique characteristics: clinically mild extensive colitis; greater incidence of backwash ileitis and rectal sparing; high risk of colorectal cancer, pouchitis and periostomal varices. After the diagnosis, annual colonoscopy with biopsies are recommended for colorectal cancer surveillance, even after liver transplant.The therapeutics are the same as standard Primary Sclerosing Cholangitis and Inflammatory Bowel Disease, but this patients have a greater risk of liver transplant and death. The use of drugs other than 5-ASA is reduced. 5-ASA, folates and UDCA chemoprotective effect is controversial. The Liver Transplant has a variable effect on the colitis course. Colorectal cancer risk remains high due to immunosuppressive therapy after liver transplant. Colectomy reduces the risk of colorectal cancer and Primary Sclerosing Cholangitis recurrence. |
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| Autores principais: | Nunes, Andreia Carina dos Santos |
| Assunto: | Doenças inflamatórias intestinais Colangite esclerosante |
| Ano: | 2014 |
| País: | Portugal |
| Tipo de documento: | dissertação de mestrado |
| Tipo de acesso: | acesso restrito |
| Instituição associada: | Universidade de Lisboa |
| Idioma: | português |
| Origem: | Repositório da Universidade de Lisboa |
| Resumo: | Inflammatory Bowel Disease associated with Primary Sclerosing Cholangitis is a rare phenotype, which is more common in men, non-smokers and has a bimodal age distribution. Genetic, immunological and infectious factors has been implicated in the ethiopathogenesis.Phenotypically it has unique characteristics: clinically mild extensive colitis; greater incidence of backwash ileitis and rectal sparing; high risk of colorectal cancer, pouchitis and periostomal varices. After the diagnosis, annual colonoscopy with biopsies are recommended for colorectal cancer surveillance, even after liver transplant.The therapeutics are the same as standard Primary Sclerosing Cholangitis and Inflammatory Bowel Disease, but this patients have a greater risk of liver transplant and death. The use of drugs other than 5-ASA is reduced. 5-ASA, folates and UDCA chemoprotective effect is controversial. The Liver Transplant has a variable effect on the colitis course. Colorectal cancer risk remains high due to immunosuppressive therapy after liver transplant. Colectomy reduces the risk of colorectal cancer and Primary Sclerosing Cholangitis recurrence. |
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