Primary sclerosing cholangitis: Diagnosis and management

  title={Primary sclerosing cholangitis: Diagnosis and management},
  author={Phunchai Charatcharoenwitthaya and Keith D. Lindor},
  journal={Current Gastroenterology Reports},
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease caused by progressive inflammatory destruction of intrahepatic and extrahepatic bile ducts, and ultimately cirrhosis. PSC occurs primarily in patients with underlying ulcerative colitis and affects primarily young to middle-aged men. PSC is believed to be an autoimmune disease mediated by immune dysregulation in patients with genetic susceptibility. One possible mechanism for the development of PSC is the homing of… 
Clinical features and management of primary sclerosing cholangitis.
Primary sclerosing cholangitis is a chronic cholestatic liver disease characterized by inflammation and fibrosis of the bile ducts, resulting in cirrhosis and need for liver transplantation and
Endoscopy in the management of primary sclerosing cholangitis
Primary sclerosing cholangitis (PSC) is a chronic, cholestatic liver condition characterized by progressive fibrosis and destruction of the intra-and extrahepatic biliary tree. PSC has a clear
Primary sclerosing cholangitis
Leukocytapheresis Therapy Improved Cholestasis in a Patient Suffering from Primary Sclerosing Cholangitis with Ulcerative Colitis
Improvement of UC, but also decreased serum alkaline phosphatase, γ-guanosine triphosphate and total bile acids, suggesting improvement of PSC-associated cholestaisis, were seen after treatment with LCAP.
Extraintestinal Manifestations of Inflammatory Bowel Disease: Primary Sclerosing Cholangitis
Primary sclerosing cholangitis (PSC) is a chronic and progressive disease of the biliary tree characterised by concentric, obliterative fibrosis leading to bile duct stricturing and eventually
An update on treatment options for primary sclerosing cholangitis
The present study aimed to review the current treatment options for patients with primary sclerosing cholangitis and suggest several treatment modalities mainly focusing on the inflammation aspect of this disorder.
Autoimmune cholangitis and cholangiocarcinoma
Correct diagnosis of IAC will avoid unnecessary surgery because IAC responds well to steroid therapy and increased IgG4 levels, other organ involvement and response to steroids are keys to distinguishing IAC from CCA.
Primary sclerosing cholangitis: role of extrahepatic biliary resection.
Biliary Stent Therapy for Dominant Strictures in Patients Affected by Primary Sclerosing Cholangitis
The aim of this article is to review the diagnostic and therapeutic strategies for patients affected by PSC and DS with specific emphasis on the outcomes of patients treated with temporary stents.


Primary sclerosing cholangitis.
Aside from viral hepatitis and alcoholic liver disease, primary sclerosing cholangitis is one of the most common indications for liver transplantation and research aimed toward better understanding the pathogenetic mechanisms and clinical trials with promising new agents are ongoing.
A Pilot Study of Etanercept in the Treatment of Primary Sclerosing Cholangitis
Etanercept, at the dosage used, was well tolerated but not effective in the treatment of PSC, although it may be helpful in treating pruritus due to cholestasis.
Ursodiol for Primary Sclerosing Cholangitis
Ursodiol (ursodeoxycholic acid) benefits patients with primary biliary cirrhosis, another cholestatic liver disease, and well-documented primary sclerosing cholangitis in a randomized, double-blind study comparing ursodiol with placebo.
Is there a role for liver biopsy in primary sclerosing cholangitis?
Liver biopsies rarely contribute new information that affects the management of patients with PSC, and given the risks of the procedure, liver biopsy for patients with a diagnosis of PSC established by cholangiography may not routinely be necessary.
Sonographic detection of perihepatic lymphadenopathy is an indicator for primary sclerosing cholangitis in patients with inflammatory bowel disease
In patients with IBD, detection of enlarged perihepatic lymph nodes in US predicted PSC more accurately than conventional serum parameters alone and the sensitivity ratio increased by a factor of 1.13 in favor of the US examination.
Risk factors for recurrence of primary sclerosing cholangitis of liver allograft
Patients with small duct primary sclerosing cholangitis have a favourable long term prognosis
Patients with small duct PSC seem to have a good prognosis in terms of survival and development of cholangiocarcinoma.
Endoscopic management of cholangiocarcinoma.
Surgical bypass was once the primary means of palliation of jaundice in patients with unresectable cholangiocarcinoma but in the last 2 decades has been superseded by less invasive and less morbid nonsurgical procedures such as endoscopic and percutaneous biliary stent placement.
Tacrolimus (FK 506), a treatment for primary sclerosing cholangitis: results of an open-label preliminary trial.
Tacrolimus (FK 506), a new and powerful immunosuppressive macrolide antibiotic, has been used to treat 10 patients with primary sclerosing cholangitis and it is anticipated that FK 506 will become an important agent for the treatment of patients with PSC because of its powerful immunOSuppressive activity.