Primary sclerosing cholangitis

Question 1

What features are present in primary sclerosing cholangitis?

Answer 1

Jaundice
Pruritis
RUQ pain
Fatigue
Hepatomegaly

Question 2

What conditions are associated with Primary sclerosing cholangitis?

Answer 2

Ulcerative colitis
Crohn’s disease
HIV

Question 3

What investigations are carried out in primary sclerosing cholangitis?

Answer 3

LFTs:
Raised ALP
Raised bilirubin
Raised AST and ALT

Autoantibodies:
p-ANCA

Gold standard:
ERCP or MRCP - show multiple biliary strictures giving a beaded appearance

Question 4

What treatment is given in primary sclerosing cholangitis?

Answer 4

ERCP to dilate and stent any strictures
Ursodeoxycholic acid
Colestyramine - for pruritus

Question 5

What complications can arise from primary sclerosing cholangitis?

Answer 5

Cholangiocarcinoma

Increased risk of colorectal cancer