A colangite esclerosante primária é relativamente rara, com incidência estimada de 1.0 a 1.5 por 100,000 pessoas-ano, e prevalência estimada de 6.0 a 16.0 por 100,000 na América do Norte e na Europa Ocidental.[3]Bowlus CL, Arrivé L, Bergquist A, et al. AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma. Hepatology. 2023 Feb 1;77(2):659-702.
https://www.doi.org/10.1002/hep.32771
http://www.ncbi.nlm.nih.gov/pubmed/36083140?tool=bestpractice.com
Entretanto, a incidência e prevalência variam geograficamente. A colangite esclerosante primária é mais comum no Norte da Europa e na América do Norte do que no Sul da Europa e no Sudeste Asiático.[9]Tabibian JH, Ali AH, Lindor KD. Primary sclerosing cholangitis, part 1: epidemiology, etiopathogenesis, clinical features, and treatment. Gastroenterol Hepatol (N Y). 2018 May;14(5):293-304.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034608
http://www.ncbi.nlm.nih.gov/pubmed/29991937?tool=bestpractice.com
No Japão, a prevalência da colangite esclerosante primária é estimada em 0.95 por 100,000.[10]Tanaka A, Takikawa H. Geoepidemiology of primary sclerosing cholangitis: a critical review. J Autoimmun. 2013 Aug 7;46:35-40.
http://www.ncbi.nlm.nih.gov/pubmed/23932346?tool=bestpractice.com
Ela é mais comum nos homens que nas mulheres, com uma razão de homens/mulheres de 2:1; embora a razão de homens/mulheres seja muito menor quando se exclui a doença inflamatória intestinal (DII).[3]Bowlus CL, Arrivé L, Bergquist A, et al. AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma. Hepatology. 2023 Feb 1;77(2):659-702.
https://www.doi.org/10.1002/hep.32771
http://www.ncbi.nlm.nih.gov/pubmed/36083140?tool=bestpractice.com
[4]Kingham JG, Kochar N, Gravenor MB. Incidence, clinical patterns and outcomes of primary sclerosing cholangitis in South Wales, United Kingdom. Gastroenterology 2004 Jun;126(7):1929-30.
http://www.ncbi.nlm.nih.gov/pubmed/15188211?tool=bestpractice.com
[6]Bambha K, Kim WR, Talwalkar J, et al. Incidence, clinical spectrum, and outcomes of primary sclerosing cholangitis in a United States community. Gastroenterology. 2003 Nov;125(5):1364-9.
http://www.ncbi.nlm.nih.gov/pubmed/14598252?tool=bestpractice.com
[8]Tischendorf JJ, Hecker H, Kruger M, et al. Characterization, outcome, and prognosis in 273 patients with primary sclerosing cholangitis: a single center study. Am J Gastroenterol. 2007 Jan;102(1):107-14.
http://www.ncbi.nlm.nih.gov/pubmed/17037993?tool=bestpractice.com
[11]Bergquist A, Said K, Broome U. Changes over a 20-year period in the clinical presentation of primary sclerosing cholangitis in Sweden. Scand J Gastroenterol. 2007 Jan;42(1):88-93.
http://www.ncbi.nlm.nih.gov/pubmed/17190768?tool=bestpractice.com
A colangite esclerosante primária pode ocorrer em qualquer idade (inclusive na infância), mas tipicamente se manifesta entre os 25 e 45 anos de idade, com uma idade média de 36-39 anos no momento do diagnóstico.[3]Bowlus CL, Arrivé L, Bergquist A, et al. AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma. Hepatology. 2023 Feb 1;77(2):659-702.
https://www.doi.org/10.1002/hep.32771
http://www.ncbi.nlm.nih.gov/pubmed/36083140?tool=bestpractice.com
Colangite esclerosante primária de pequenos ductos (representando 3% a 16% dos casos) é menos comum que colangite esclerosante primária de grandes ductos (clássica).[5]Kaplan GG, Laupland KB, Butzner D, et al. The burden of large and small duct primary sclerosing cholangitis in adults and children: a population-based analysis. Am J Gastroenterol. 2007 May;102(5):1042-9.
http://www.ncbi.nlm.nih.gov/pubmed/17313496?tool=bestpractice.com
[8]Tischendorf JJ, Hecker H, Kruger M, et al. Characterization, outcome, and prognosis in 273 patients with primary sclerosing cholangitis: a single center study. Am J Gastroenterol. 2007 Jan;102(1):107-14.
http://www.ncbi.nlm.nih.gov/pubmed/17037993?tool=bestpractice.com
[11]Bergquist A, Said K, Broome U. Changes over a 20-year period in the clinical presentation of primary sclerosing cholangitis in Sweden. Scand J Gastroenterol. 2007 Jan;42(1):88-93.
http://www.ncbi.nlm.nih.gov/pubmed/17190768?tool=bestpractice.com
[12]Angulo P, Maor-Kendler Y, Lindor K. Small-duct primary sclerosing cholangitis: a long-term follow-up study. Hepatology. 2002 Jun;35(6):1494-500.
http://www.ncbi.nlm.nih.gov/pubmed/12029635?tool=bestpractice.com
A síndrome de sobreposição colangite esclerosante primária-hepatite autoimune ocorre mais frequentemente em crianças que em adultos, representando 35% e 5% dos casos, respectivamente.[3]Bowlus CL, Arrivé L, Bergquist A, et al. AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma. Hepatology. 2023 Feb 1;77(2):659-702.
https://www.doi.org/10.1002/hep.32771
http://www.ncbi.nlm.nih.gov/pubmed/36083140?tool=bestpractice.com
Pacientes com sobreposição de hepatite autoimune são tipicamente mais jovens na apresentação (idade média na apresentação de 21.4 anos versus 32.3 anos com colangite esclerosante primária clássica).[7]Floreani A, Rizzotto ER, Ferrara F, et al. Clinical course and outcome of autoimmune hepatitis/primary sclerosing cholangitis overlap syndrome. Am J Gastroenterol. 2005 Jul;100(7):1516-22.
http://www.ncbi.nlm.nih.gov/pubmed/15984974?tool=bestpractice.com
Muitos pacientes com colangite esclerosante primária têm DII associada (normalmente, colite ulcerativa) - as estimativas variam de 50% a mais de 80% - e estima-se que 0.6% a 4.3% dos pacientes com DII tenham colangite esclerosante primária.[2]European Association for the Study of the Liver. EASL clinical practice guidelines on sclerosing cholangitis. J Hepatol. 2022 Sep;77(3):761-806.
https://www.doi.org/10.1016/j.jhep.2022.05.011
http://www.ncbi.nlm.nih.gov/pubmed/35738507?tool=bestpractice.com
[3]Bowlus CL, Arrivé L, Bergquist A, et al. AASLD practice guidance on primary sclerosing cholangitis and cholangiocarcinoma. Hepatology. 2023 Feb 1;77(2):659-702.
https://www.doi.org/10.1002/hep.32771
http://www.ncbi.nlm.nih.gov/pubmed/36083140?tool=bestpractice.com
[9]Tabibian JH, Ali AH, Lindor KD. Primary sclerosing cholangitis, part 1: epidemiology, etiopathogenesis, clinical features, and treatment. Gastroenterol Hepatol (N Y). 2018 May;14(5):293-304.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6034608
http://www.ncbi.nlm.nih.gov/pubmed/29991937?tool=bestpractice.com
[13]Karlsen TH, Folseraas T, Thorburn D, et al. Primary sclerosing cholangitis - a comprehensive review. J Hepatol. 2017 Aug 10;67(6):1298-323.
https://www.journal-of-hepatology.eu/article/S0168-8278(17)32196-7/fulltext
http://www.ncbi.nlm.nih.gov/pubmed/28802875?tool=bestpractice.com
A associação com a DII varia geograficamente, com uma associação mais baixa em pacientes da Ásia e do sul da Europa.[14]Escorsell A, Pares A, Rodes J, et al. Epidemiology of primary sclerosing cholangitis in Spain. Spanish Association for the Study of the Liver. J Hepatol. 1994 Nov;21(5):787-91.
http://www.ncbi.nlm.nih.gov/pubmed/7890895?tool=bestpractice.com
[15]Takikawa H. Characteristics of primary sclerosing cholangitis in Japan. Hepatol Res. 2007 Oct;37 Suppl 3:S470-3.
http://www.ncbi.nlm.nih.gov/pubmed/17931205?tool=bestpractice.com