Universität zu Köln

Abdulkarim, Mosaab, Zenouzi, Roman, Sebode, Marcial, Schulz, Lisa, Quaas, Alexander, Lohse, Ansgar W., Schramm, Christoph and Weiler-Normann, Christina (2019). Sex differences in clinical presentation and prognosis in patients with primary biliary cholangitis. Scand. J. Gastroenterol., 54 (11). S. 1391 - 1397. ABINGDON: TAYLOR & FRANCIS LTD. ISSN 1502-7708

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Abstract

Objectives: Primary biliary cholangitis (PBC) is a chronic inflammatory disease of the small intrahepatic bile ducts disproportionally affecting women. Timely diagnosis and treatment can often prevent progression to liver cirrhosis. We hypothesized PBC diagnosis in male patients is delayed and prognosis impaired. We, therefore, conducted a case-control study and compared clinical and prognostic features among male and female patients with PBC. Materials and methods: 49 male patients with PBC treated at a German tertiary care center between 2006 and 2017 were identified and compared to 98 age-matched female controls. Prospectively collected clinical/biochemical data were analyzed retrospectively. Liver biopsies were scored in a blinded fashion. Prognostic parameters were calculated using established prognostic scores (GLOBE, PBC-UKE). Statistical analysis was performed using Mann-Whitney test and Fisher ' s exact test. Results: At PBC diagnosis, male patients reported significantly less PBC-associated symptoms as compared to female controls (34 versus 71%, p < .01). Compared to female patients, median time from onset of PBC-related symptoms and/or first reported elevated cholestatic biochemical parameters to PBC diagnosis was significantly increased in men (36 versus 12 months, p = .02). In addition, male patients underwent liver biopsy to establish PBC diagnosis more frequently, tended to show more advanced fibrosis and showed significantly poorer prognostic PBC score results. Hepatocellular carcinoma was only observed in male patients (n = 3). Conclusions: When compared to women, men with PBC suffer from less PBC-related symptoms, receive PBC diagnosis delayed and have a worse prognosis. Despite its rarity, the diagnosis of PBC should be considered in men with elevated cholestatic parameters.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Abdulkarim, Mosaab UNSPECIFIED UNSPECIFIED UNSPECIFIED Zenouzi, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED Sebode, Marcial UNSPECIFIED UNSPECIFIED UNSPECIFIED Schulz, Lisa UNSPECIFIED UNSPECIFIED UNSPECIFIED Quaas, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Lohse, Ansgar W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schramm, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiler-Normann, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-128216
DOI:	10.1080/00365521.2019.1683226
Journal or Publication Title:	Scand. J. Gastroenterol.
Volume:	54
Number:	11
Page Range:	S. 1391 - 1397
Date:	2019
Publisher:	TAYLOR & FRANCIS LTD
Place of Publication:	ABINGDON
ISSN:	1502-7708
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language QUALITY-OF-LIFE; NATURAL-HISTORY; RISK-FACTORS; CIRRHOSIS; GENDER; MEN; EPIDEMIOLOGY; PREVALENCE; DIAGNOSIS; FATIGUE Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/12821