Diagnosis and classification of primary sclerosing cholangitis.

Abstract:

:Primary sclerosing cholangitis (PSC) is a chronic cholestatic disease of the liver and that is characterized by progressive inflammation, fibrosis, and stricturing of the intrahepatic and extrahepatic bile ducts. It is progressive in most patients and leads to cirrhosis. It is a rare disease, mostly affecting people of northern European descent, males greater than females. The diagnosis is best established by contrast cholangiography, which reveals a characteristic picture of diffuse, multifocal strictures and focal dilation of the bile ducts, leading to a beaded appearance. Inflammatory bowel disease (IBD) is present in ~75% of the patients with PSC, mostly ulcerative colitis (~85% of the cases). In addition to biliary cirrhosis, complications of PSC include dominant strictures of the bile ducts, cholangitis, cholangiocarcinoma, colon dysplasia and cancer in patients with IBD, gallbladder polyps and cancer, and hepatic osteodystrophy. The etiology of PSC is not clear, but studies are ongoing. The median survival without liver transplantation is 12 to 15 years after diagnosis. Currently there are no effective treatments except liver transplantation. Immunosuppressive medications have not been shown to be effective but antibiotics and anti-fibrotic agents seem promising.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

Yimam KK,Bowlus CL

doi

10.1016/j.autrev.2014.01.040

subject

Has Abstract

pub_date

2014-04-01 00:00:00

pages

445-50

issue

4-5

eissn

1568-9972

issn

1873-0183

pii

S1568-9972(14)00052-4

journal_volume

13

pub_type

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