Ulcerative colitis (UC) is a chronic inflammatory disease in which clinical course varies substantially between patients.
The extent of the disease is usually pointed out as one of the factors
responsible for this variation. With this study, we pretended to evaluate the differences in natural history and pharmacological therapy
prescription between left-sided and extended UC

Antunes, A.

Belo, T.

Caldeira, Paulo

Eusébio, Marta

Gago, T.

Guerreiro, H.

Queiros, P.

Vaz, A.

Journal of Crohn s and Colitis

English

Eusébio, M.

Caldeira, P.

Universidade do Algarve

P417
Ulcerative colitis: let’s talk about extent
A. Vaz*, M.  Eusébio, A.  Antunes, P.  Queirós, T.  Gago, T.  Belo, 
P. Caldeira, H. Guerreiro
Centro Hospitalar do Algarve, Faro, Portugal
Background: Ulcerative colitis (UC) is a chronic inflammatory dis-
ease in which clinical course varies substantially between patients. 
The extent of the disease is usually pointed out as one of the factors 
responsible for this variation. With this study, we pretended to evalu-
ate the differences in natural history and pharmacological therapy 
prescription between left-sided and extended UC.
Methods: Retrospective cohort study including patients diagnosed 
with UC within our department since 2000 and with at least 1-year 
of follow-up.
Results: In total, 108 patients were included, 54.6% males, with a 
mean age at diagnosis of 37.7 ± 16 years. At diagnosis, 63 patients 
(58.3%) presented with left-sided UC, and 45 patients (41.7%) 
with extensive UC. In 4 patients (3.7%), there was progression 
from left-sided to extensive UC. Regarding the natural history of 
the disease, there were no statistical differences in the total num-
ber of crisis, severe crisis, or corticosteroid cycles between the 2 
types of UC. However, the total number of crisis was slightly supe-
rior in patients with left-sided colitis. Regarding immunomodula-
tors, there was a significantly greater prescription in patients with 
extensive UC (40% vs 22%; p < 0.05). There was no statistical 
difference in time, number of crisis or corticosteroid cycles until 
the prescription of immunomodulators, although all of these were 
also superior in left-sided UC. As for biologics, they were equally 
administered in both groups (10.1% vs 13.3%), but the time until 
prescription was significantly lower in extensive UC patients (6.25 
vs 1.93 years; p < 0.05).
Conclusions: In this study, we did not find significant differences 
between the clinical course of left-sided and extensive UC. However, 
a more conservative therapeutic attitude seems to exist in left-sided 
ulcerative colitis, which may explain the tendency for the higher 
number of crisis observed.
P418
Ulcerative colitis and end-stage liver disease in 
children with primary sclerosing cholangitis
P. Czubkowski*, M.  Wozniak, J.  Pawlowska, I.  Jankowska, 
J. Kierkus
The Children’s Memorial Health Institute, Department of 
Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, 
Warsaw, Poland
Background: Primary sclerosing cholangitis (PSC) is a progressive, 
cholestatic disorder characterised by chronic inflammation, biliary 
strictures, and frequent co-morbidity with ulcerative colitis (UC). 
Patients are at an increased risk of malignancy arising from the 
colon, bile ducts, and liver. The aim of the study was to analyse the 
influence of end-stage liver disease (ESLD) and liver transplantation 
(LTx) on the course of UC in children.
Methods: We retrospectively reviewed children diagnosed with UC 
and PSC treated in our institution between 2000 and 2015 who 
developed ESDL. UC diagnosis was based on clinical presentation, 
endoscopy, and histopathology. PSC was confirmed by endoscopic 
retrograde cholangiopancreatography, magnetic resonance cholan-
giopancreatography, and liver biopsy.
Results: Out of 12 patients with PSC and UC who developed 
ESLD, 10 underwent LTx at the median age of 16.2 years (11.5–
17.5), and 2 are currently on the waiting list. In 11 patients, 
UC was diagnosed before ESLD at the median age of 11  years 
(4–17), and one patient developed UC 6 months after transplan-
tation. Further, 10 patients (83%) presented with pancolitis, and 
2 with proctosigmoiditis. Severe, moderate, and mild endoscopic 
changes were present in 7 (58%), 3 (25%), and 2 (16%) patients, 
respectively. Initial treatment consisted of mesalazyne or sul-
fasalazine in combination with steroids and azathioprine (AZA) 
with clinical remission in 75%. Three non-responding patients 
required cyclosporine with good outcome. None of the patients 
received anti-TNF treatment. At the moment of LTx or listing (at 
median 5 years [range 1–12] after onset of UC) clinical activity 
according to PUCAI was remission in 8, moderate in 1, and mild 
Figure 2. Changes in CCPKnow scores for interactive and basic text groups.
Abstracts of the 11th Congress of ECCO - European Crohn’s and Colitis Organisation S309
D
ow
nloaded from
 https://academ
ic.oup.com
/ecco-jcc/article-abstract/10/suppl_1/S309/2482216 by B-O
n C
onsortium
 Portugal user on 13 M
ay 2020


Ulcerative colitis: let's talk about extent

Sapientia

P417Ulcerative colitis: let’s talk about extentA. Vaz*, M.  Eusébio, A.  Antunes, P.  Queirós, T.  Gago, T.  Belo, P. Caldeira, H. GuerreiroCentro Hospitalar do Algarve, Faro, PortugalBackground: Ulcerative colitis (UC) is a chronic inflammatory dis-ease in which clinical course varies substantially between patients. The extent of the disease is usually pointed out as one of the factors responsible for this variation. With this study, we pretended to evalu-ate the differences in natural history and pharmacological therapy prescription between left-sided and extended UC.Methods: Retrospective cohort study including patients diagnosed with UC within our department since 2000 and with at least 1-year of follow-up.Results: In total, 108 patients were included, 54.6% males, with a mean age at diagnosis of 37.7 ± 16 years. At diagnosis, 63 patients (58.3%) presented with left-sided UC, and 45 patients (41.7%) with extensive UC. In 4 patients (3.7%), there was progression from left-sided to extensive UC. Regarding the natural history of the disease, there were no statistical differences in the total num-ber of crisis, severe crisis, or corticosteroid cycles between the 2 types of UC. However, the total number of crisis was slightly supe-rior in patients with left-sided colitis. Regarding immunomodula-tors, there was a significantly greater prescription in patients with extensive UC (40% vs 22%; p < 0.05). There was no statistical difference in time, number of crisis or corticosteroid cycles until the prescription of immunomodulators, although all of these were also superior in left-sided UC. As for biologics, they were equally administered in both groups (10.1% vs 13.3%), but the time until prescription was significantly lower in extensive UC patients (6.25 vs 1.93 years; p < 0.05).Conclusions: In this study, we did not find significant differences between the clinical course of left-sided and extensive UC. However, a more conservative therapeutic attitude seems to exist in left-sided ulcerative colitis, which may explain the tendency for the higher number of crisis observed.P418Ulcerative colitis and end-stage liver disease in children with primary sclerosing cholangitisP. Czubkowski*, M.  Wozniak, J.  Pawlowska, I.  Jankowska, J. KierkusThe Children’s Memorial Health Institute, Department of Gastroenterology, Hepatology, Feeding Disorders and Paediatrics, Warsaw, PolandBackground: Primary sclerosing cholangitis (PSC) is a progressive, cholestatic disorder characterised by chronic inflammation, biliary strictures, and frequent co-morbidity with ulcerative colitis (UC). Patients are at an increased risk of malignancy arising from the colon, bile ducts, and liver. The aim of the study was to analyse the influence of end-stage liver disease (ESLD) and liver transplantation (LTx) on the course of UC in children.Methods: We retrospectively reviewed children diagnosed with UC and PSC treated in our institution between 2000 and 2015 who developed ESDL. UC diagnosis was based on clinical presentation, endoscopy, and histopathology. PSC was confirmed by endoscopic retrograde cholangiopancreatography, magnetic resonance cholan-giopancreatography, and liver biopsy.Results: Out of 12 patients with PSC and UC who developed ESLD, 10 underwent LTx at the median age of 16.2 years (11.5–17.5), and 2 are currently on the waiting list. In 11 patients, UC was diagnosed before ESLD at the median age of 11  years (4–17), and one patient developed UC 6 months after transplan-tation. Further, 10 patients (83%) presented with pancolitis, and 2 with proctosigmoiditis. Severe, moderate, and mild endoscopic changes were present in 7 (58%), 3 (25%), and 2 (16%) patients, respectively. Initial treatment consisted of mesalazyne or sul-fasalazine in combination with steroids and azathioprine (AZA) with clinical remission in 75%. Three non-responding patients required cyclosporine with good outcome. None of the patients received anti-TNF treatment. At the moment of LTx or listing (at median 5 years [range 1–12] after onset of UC) clinical activity according to PUCAI was remission in 8, moderate in 1, and mild Figure 2. Changes in CCPKnow scores for interactive and basic text groups.Abstracts of the 11th Congress of ECCO - European Crohn’s and Colitis Organisation S309Downloaded from https://academic.oup.com/ecco-jcc/article-abstract/10/suppl_1/S309/2482216 by B-On Consortium Portugal user on 13 May 2020

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Ulcerative colitis: let's talk about extent

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