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PRIMARY SCLEROSING CHOLANGITIS

Gastroenterology

PRIMARY SCLEROSING CHOLANGITIS

1. Primary sclerosing cholangitis (PSC): also indolent. It primarily occurs in males (70%) with average age of 45.

2. PSC is strongly associated with colitis-so it is mainly seen in ulcerative colitis (up to 75% of PSC patients have UC!), but it can occur in patients with Crohn coli­tis as well.

3. Conversely, PSC may precede the diagnosis of UC; therefore, any UC patients with a persistent, 2x increase in ALP should be screened for PSC.

4. Remember: When a patient presents with jaundice and increased ALP and has a history of chronic diarrhea or IBD, especially UC, rule out PSC with MRCP or ERCP!

5. Again, PSC: sclerosing cholangitis, colitis, high cholestatic bili, and ALP; nega­tive antimitochondrial antibody, cirrhosis, and liver failure. Abnormal MRCP, ERCP.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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