Liver disease in ulcerative colitis: an epidemiological and follow up study in the county of Stockholm
Open accessAbstract
In an epidemiological study of the incidence of ulcerative colitis (UC) in the county of Stockholm between 1955 and 1979, 1274 patients with UC were discovered. Almost all these patients had regularly been investigated with liver function tests; 142 (11%) of them showed signs of hepatobiliary disease. A follow up study on all 142 patients with abnormal liver function and UC was made between 1989 and 1991 to evaluate the cause of the liver abnormality and to find out if the liver disease had affected the survival rates. At follow up, eight patients were reclassified as having Crohn's disease, 60 had developed normal liver function as judged from test results, while the remaining 74 still had signs of hepatobiliary disease. The most common explanation for a transient abnormality in liver function was active colitis. The temporary signs of liver injury were not associated with changes in survival rates for these patients. Infections, especially those because of hepatitis B and C virus transmitted by blood transfusions accounted for the abnormalities in liver function in 21 patients, nine of which had a chronic, but non-fatal course. Twenty nine (2.3%) of the patients developed primary sclerosing cholangitis (PSC), and 12 of them died during the study period four because of cholangiocarcinoma and eight because of hepatic failure; one patient had a transplant. The estimated median time of survival from the first presentation of evidence of a liver function, compatible with the diagnosis of PSC, to death or liver transplantation was 21 years. A comparison of survival rates in patients with UC and patients with UC and concurrent PSC showed, a significant reduction in survival in the PSC group (p<0.0001). The number of patients with UC who developed PSC remained constant during the study period. Thus, although evidence of abnormal liver function is a common finding in UC, a spontaneous return to normal levels is common. In this study, which did not have a selection bias, the median time of survival among PSC patients was far longer than previously described although development of PSC among patients with UC does significantly reduce the estimated median time of survival.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The prevalence of PSC in extensive colitis IBD is around 5%.
“The prevalence of PSC in extensive colitis IBD is around 5%. 345,348”
From EASL Clinical Practice Guidelines on sclerosing cholangitis (2022) · cites this paper as [345]
Abnormal liver function tests are common in IBD and reported in nearly 30% of patients, but underlying liver disease is much rarer.
“Abnormal liver function tests are common in IBD and reported in nearly 30% of patients, but underlying liver disease is much rarer.344,345”
From EASL Clinical Practice Guidelines on sclerosing cholangitis (2022) · cites this paper as [345]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Chapman, R. W., Arborgh, B., Rhodes, J. M., Summerfield, J. A., Dick, R., Scheuer, P. J., & Sherlock, S. (1980) · Gut · doi:10.1136/gut.21.10.870 · Cited by 732 · see citing works
Primary sclerosing cholangitis: Natural history, prognostic factors and survival analysis
Wiesner, R. H., Grambsch, P. M., Dickson, E. R., Ludwig, J., MacCarty, R. L., Hunter, E. B., Fleming, T. R., Fisher, L. D., Beaver, S. J., & LaRusso, N. F. (1989) · Hepatology · doi:10.1002/hep.1840100406 · Cited by 641 · see citing works
MacSween, N. M. R. (1979) · Churchill Livingstone eBooks · Cited by 572 · see citing works
Natural history and prognostic variables in primary sclerosing cholangitis
Farrant, J. M., Hayllar, K. M., Wilkinson, M. L., Karani, J., Portmann, B. C., Westaby, D., & Williams, R. (1991) · Gastroenterology · doi:10.1016/0016-5085(91)90673-9 · Cited by 468 · see citing works
Prevalence of Primary Sclerosing Cholangitis in Patients With Ulcerative Colitis
Olsson, R., Danielsson, Å., Järnerot, G., Lindström, E., Lööf, L., Rolny, P., Rydén, B.-O., Tysk, C., & Wallerstedt, S. (1991) · Gastroenterology · doi:10.1016/0016-5085(91)70019-t · Cited by 424 · see citing works
Cholangiocarcinoma Complicating Primary Sclerosing Cholangitis
Rosen, C. B. B., Nagorney, D. M., Wiesner, R. H., Coffey, R. J., & LaRusso, N. F. (1991) · Annals of Surgery · doi:10.1097/00000658-199101000-00004 · Cited by 389 · see citing works
An epidemiological study of ulcerative colitis and regional enteritis in the Oxford area.
Evans, J., & Acheson, E. D. (1965) · Gut · doi:10.1136/gut.6.4.311 · Cited by 301 · see citing works
Primary Sclerosing Cholangitis: A Long-Term Follow-up Study
Aadland, E., Schrumpf, E., FAUSA, O., Elgjo, K. M., Heilo, A., Aakhus, T., & Gjone., E. (1987) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528709011139 · Cited by 274 · see citing works
Hultcrantz, R., Glaumann, H., Lindberg, G., & Nilsson, L. H. (1986) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528609034632 · Cited by 261 · see citing works
Self-citationSclerosing Cholangitis in Ulcerative Colitis
Schrumpf, E., Elgjo, K. M., FAUSA, O., Gjone., E., Kolmannskog, F., & Ritland, S. (1980) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528009181516 · Cited by 206 · see citing works
Wee, A., & LUDWIG, J. (1985) · Annals of Internal Medicine · doi:10.7326/0003-4819-102-5-581 · Cited by 198 · see citing works
Ulcerative Colitis and Persistent Liver Dysfunction
Shepherd, H. A., Selby, W. S., Chapman, R. W., Nolan, D. J., Barbatis, C., McGee, J. O., & Jewell, D. P. (1983) · QJM · doi:10.1093/oxfordjournals.qjmed.a067776 · Cited by 139 · see citing works
Prevalence of primary sclerosing cholangitis in patients with ulcerative colitis
Olsson, R., Danielsson, Å., Järnerot, G., et al. (1991) · Gastroenterology · doi:10.1016/0016-5085(91)90784-i · Cited by 126 · see citing works
Liver Disease in Ulcerative Colitis
Eade, M. N. (1970) · Annals of Internal Medicine · doi:10.7326/0003-4819-72-4-475 · Cited by 110 · see citing works
Primary sclerosing cholangitis with normal serum alkaline phosphatase activity
Balasubramaniam, K., Wiesner, R. H., & LaRusso, N. F. (1988) · Gastroenterology · doi:10.1016/0016-5085(88)90378-2 · Cited by 100 · see citing works
Incidence of Ulcerative Colitis in Stockholm County 1955–1979
Nordenvall, B., Broström, O., Berglund, M., Monsén, U., Nordenström, J., Sörstad, J., & Hellers, G. (1985) · Scandinavian Journal of Gastroenterology · doi:10.3109/00365528509088823 · Cited by 93 · see citing works
Self-citationHepatic Lesions in Chronic Inflammatory Bowel Disease
Dordal, E., Glagov, S., & Kirsner, J. B. (1967) · Gastroenterology · doi:10.1016/s0016-5085(67)80013-1 · Cited by 90 · see citing works
Pitfalls in Epidemiological Research
Enterline, P. E. (1976) · Journal of Occupational and Environmental Medicine · doi:10.1097/00043764-197603000-00006 · Cited by 86 · see citing works
The Spectrum of Hepatic Dysfunction in Inflammatory Bowel Disease
Dew, M. J., Thompson, H., & Allan, R. N. (1979) · QJM · doi:10.1093/oxfordjournals.qjmed.a067561 · Cited by 71 · see citing works
Kleckner, M. S., Stauffer, M. H., Bargen, J. A., & Dockerty, M. B. (1952) · Gastroenterology · doi:10.1016/s0016-5085(19)36358-9 · Cited by 63 · see citing works
Diseases of the Liver and Biliary System. 8th ed
Sherlock, S. (1990) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-199008000-00036 · Cited by 56 · see citing works
Diseases of the liver and biliary system
Triger, D. R. (1990) · Gut · doi:10.1136/gut.31.4.485-a · Cited by 50 · see citing works
Bengoa, J. M., Hanauer, S. B., Sitrin, M. D., et al. (1985) · Hepatology · doi:10.1002/hep.1840050117 · Cited by 48 · see citing works
Liver damage in ulcerative colitis.
Kimmelstiel, P., Hl, L., & Hd, V. (2004) · PubMed · Cited by 45 · see citing works
Hepatobiliary complications of ulcerative colitis
Lupinetti, M., Mehigan, D., & Cameron, J. L. (1980) · The American Journal of Surgery · doi:10.1016/0002-9610(80)90239-1 · Cited by 38 · see citing works
Primary biliary cirrhosis and ulcerative colitis
Bush, A., Mitchison, H., Walt, R. P., Baron, J. H., Boylston, A. W., & Summerfield, J. A. (1987) · Gastroenterology · doi:10.1016/0016-5085(87)90636-6 · Cited by 33 · see citing works
Olsson, R., & Hultén, L. (1975) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.1975.12096974 · Cited by 30 · see citing works
Primary Biliary Cirrhosis and Chronic Pancreatitis in a Patient with Ulcerative Colitis
Kato, Y., Morimoto, H., Unoura, M., et al. (1985) · Journal of Clinical Gastroenterology · doi:10.1097/00004836-198510000-00011 · Cited by 25 · see citing works
Olsson, R., & Hultén, L. (1975) · PubMed · Cited by 25 · see citing works
Hepatic Histological Changes in Ulcerative Colitis
de Dombal, F. T., Goldie, W., Watts, J. M., & Goligher, J. C. (1966) · Scandinavian Journal of Gastroenterology · doi:10.1080/00365521.1966.11800636 · Cited by 23 · see citing works
de Dombal, F. T., Goldie, W., Watts, J. M., & Goligher, J. C. (1966) · PubMed · Cited by 18 · see citing works
Bile duct carcinoma associated with ulcerative colitis.
Akwari, O. E., van Heerden, J. A., Adson, M. A., et al. (1976) · PubMed · Cited by 16 · see citing works
Flagged first, then by citations
Research works printed but not linked: 3
- -1 uu r -801 on August 10, 2023 by guest. Protected by copyright. http://gut.bmj.com/ Gut: first published as 10.1136/gut.35.1.84 on 1 January 1994. Downloaded from
- Thomas CH. Ulceration of the colon with a much enlarged fatty liver. Trans Pathol Soc Philadelphia 1873; 4: 87-8.
- Lupinetti M, Mehigan H, Cameron J. Hepatobiliary compli- cations in ulcerative colitis. AmJ Surg 1980; 139: 113-8.
Cited by
Sorted by citations
Soetikno, R. M., Lin, O. S., Heidenreich, P. A., Young, H. S., & Blackstone, M. O. (2002) · Gastrointestinal Endoscopy · doi:10.1067/mge.2002.125367 · Cited by 623 · see citing works
EASL Clinical Practice Guidelines on sclerosing cholangitis
Chazouilleres, O., Beuers, U., Bergquist, A., Karlsen, T. H., Levy, C., Samyn, M., Schramm, C., & Trauner, M. (2022) · Journal of Hepatology · doi:10.1016/j.jhep.2022.05.011 · Cited by 419 · see citing works
A preliminary trial of high-dose ursodeoxycholic acid in primary sclerosing cholangitis
Mitchell, S. A., Bansi, D. S., Hunt, N., Bergmann, K. V., Fleming, K. A., & Chapman, R. W. (2001) · Gastroenterology · doi:10.1053/gast.2001.27965 · Cited by 351 · see citing works
Lundqvist, K., & Broomé, U. (1997) · Diseases of the Colon & Rectum · doi:10.1007/bf02258391 · Cited by 159 · see citing works
Self-citationBarberio, B., Massimi, D., Cazzagon, N., Zingone, F., Ford, A. C., & Savarino, E. V. (2021) · Gastroenterology · doi:10.1053/j.gastro.2021.08.032 · Cited by 152 · see citing works
Abnormal hepatic biochemistries in patients with inflammatory bowel disease
Mendes, F. D., Levy, C., Enders, F. B., Loftus, E. V., Angulo, P., & Lindor, K. D. (2007) · The American Journal of Gastroenterology · doi:10.1111/j.1572-0241.2006.00947.x · Cited by 147 · see citing works
Hultcrantz, R., Olsson, R., Danielsson, Å., Järnerot, G., Lööf, L., Ryden, B. O., Wahren, B., & Broomé, U. (1999) · Journal of Hepatology · doi:10.1016/s0168-8278(99)80198-6 · Cited by 107 · see citing works
Self-citationOlsson, R., Glaumann, H., Almer, S., Broomé, U., Lebrun, B., Bergquist, A., Björnsson, E., Prytz, H., Danielsson, Å., & Lindgren, S. (2009) · European Journal of Internal Medicine · doi:10.1016/j.ejim.2008.06.004 · Cited by 79 · see citing works
Self-citation
- Authors
- Broomé, U., Glaumann, H., Hellers, G., Nilsson, B., Sörstad, J., & Hultcrantz, R.
- Affiliations
- Karolinska Institutet (SE)
- Venue
- Gut
- Publisher
- BMJ
- Published
- 1994-01
- Volume
- 35
- Issue
- 1
- Pages
- 84-89
- ISSN
- 0017-5749 (ISSN-L)
- 1468-3288
- PMC
- PMC1374638
- OpenAlex
- W1984348904
- Cited by
- 147
- References
- 32
- Citations by year
- 2026: 1 · 2025: 2 · 2024: 5 · 2023: 2 · 2022: 6 · 2021: 1 · 2020: 1 · 2018: 2 · 2017: 4 · 2016: 3 · 2015: 5 · 2014: 8 · 2013: 4 · 2012: 6
- FWCI
- 4.95
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Gut (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Hepatology › Liver Diseases and Immunity
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Inflammatory Bowel Disease
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Drug-Induced Hepatotoxicity and Protection
- Keywords
- ulcerative colitis, primary sclerosing cholangitis, hepatobiliary diseases, liver function tests, incidence, survival, cholangiocarcinoma, liver failure, Crohn's disease, liver transplantation
- MeSH terms
- Adolescent, Adult, Aged, Cause of Death, Child, Colitis, Ulcerative, Female, Follow-Up Studies, Humans, Liver, Liver Diseases, Male, Middle Aged, Remission, Spontaneous, Sweden, Cholangitis, Sclerosing
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
