Clinical features and course of ulcerative colitis diagnosed in asymptomatic subjects |
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| Affiliation: | 1. Department of Gastroenterology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea;2. Inflammatory Bowel Disease Center, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea;3. Department of Clinical Epidemiology and Biostatistics, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea;4. Department of Pathology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea;5. Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea;1. Department of Pathobiology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA;2. Department of Gastroenterology & Hepatology, Lerner Research Institute, Cleveland Clinic Foundation, Cleveland, OH, USA;3. Academic Medical Center Amsterdam, Tytgat Institute for Liver and Intestinal Research, Amsterdam, The Netherlands;4. Division of Pharmaceutical Technology and Biopharmacy, Department of Pharmacy, University of Groningen, The Netherlands;5. Department of Gastroenterology, University Hospital of Ioannina, Medical School of Ioannina, Greece;6. Division of Gastroenterology, University Hospital Careggi, Florence, Italy;7. Division of Gastroenterology, University of Michigan, Ann Arbor, MI, USA;8. Department of Pharmacology & Therapeutics, Institute for Molecular and Cell Biology, Faculty of Medicine University of Porto, Porto, Portugal;9. IBD Center, Department of Gastroenterology and Liver Diseases, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel;10. Department of Gastroenterology, Hospital de Sao Joao, Porto, Portugal;11. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel;1. Gastroenterology Department, Centro Hospitalar São João, Porto, Portugal;2. Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Porto, Portugal;3. MedInUP — Center for Drug Discovery and Innovative Medicines, University of Porto, Porto, Portugal;1. Department of Abdominal Surgery, University Hospital Gasthuisberg Leuven, Belgium;2. Department of Gastroenterology, University Hospital Gasthuisberg Leuven, Belgium;3. Interuniversity Center for Biostatistics and Statistical Bioinformatics, University Hospital Gasthuisberg Leuven, Belgium |
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| Abstract: | Background and AimsAlthough some ulcerative colitis (UC) patients are diagnosed when they do not have any UC-related symptoms, clinical features and prognosis of UC diagnosed in asymptomatic patients remain unclear.MethodsData for UC patients who were asymptomatic at diagnosis were retrospectively reviewed from the IBD database of the Asan Medical Center. The clinical characteristics and prognosis of those patients were analyzed and compared with matched (1:4) symptomatic UC patients.ResultsOnly nineteen asymptomatic UC patients (1.1%) were identified from 1665 UC patients. The proportion of males was 78.9% (n = 15), and their median age at diagnosis was 48 years (range, 34–71 years). At diagnosis, proctitis was noted in 11 patients (57.9%), left-sided colitis in 4 (21.1%), extensive colitis in 0 (0%), and atypical distribution in 4 (21.1%). The 5-year cumulative probability of symptom development was 68.5% (95% confidence interval [CI], 62.8%–74.2%). After UC diagnosis, oral 5-aminisalicylic acid (ASA) and topical 5-ASA were used in 14 (73.7%) and 16 (84.2%) patients, respectively. During follow-up (3.7-year median for asymptomatic patients versus 3.7-year median for symptomatic patients; P = 0.961), the 5-year cumulative probability of corticosteroids (23.7% versus 57.1%; P = 0.022) and azathioprine (0% versus 24.7%; P = 0.003) use was higher in symptomatic patients than in asymptomatic patients.ConclusionsThe frequency of asymptomatic UC patients was 1.1% in our UC patient cohort. A majority of these patients became symptomatic during follow-up. Asymptomatic UC patients at diagnosis appear to have a better prognosis than symptomatic UC patients. |
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