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PRIMARY SCLEROSING CHOLANGITIS-INVESTIGATIONS

Gastroenterology

PRIMARY SCLEROSING CHOLANGITIS-INVESTIGATIONS

1. Bilirubin and alkaline phosphatase levels are elevated (cholestatic pattern).

2. There is an elevated hepatic copper level (as in primary biliary cirrhosis and Wilson disease), but the antimitochondrial antibody is negative.

3. The total protein level gives an idea of how much the disease has affected liver function.

4. Diagnosis of PSC is made with MRCP, ERCP, or transhepatic cholangiography. With ERCP, if a dominant stricture exists, it can be dilated.

5. These reveal irregularly narrowed bile ducts with small bile duct ballooning just prior to obstructions, producing the typical "beaded" appearance.

6. Liver biopsy shows "onion skin" fibrosis in portal triads.


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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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