Diagnosis and classification of primary sclerosing cholangitis

Kidist K. Yimam, Christopher Bowlus

Research output: Contribution to journalArticle

35 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)445-450
Number of pages6
JournalAutoimmunity Reviews
Volume13
Issue number4-5
DOIs
StatePublished - 2014

Keywords

  • Clinical manifestation
  • Etiopathogenesis inflammatory bowel disease
  • Liver transplantation
  • Primary sclerosis cholangitis

ASJC Scopus subject areas

  • Immunology
  • Immunology and Allergy

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