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Sclair SN, Little E, Levy C. Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis. Clin Transl Gastroenterol. 2015;6:e109doi: 10.1038/ctg.2015.33.
Sclair, S. N., Little, E., & Levy, C. (2015). Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis. Clinical and translational gastroenterology, 6e109. https://doi.org/10.1038/ctg.2015.33
Sclair, Seth N, et al. "Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis." Clinical and translational gastroenterology vol. 6 (2015): e109. doi: https://doi.org/10.1038/ctg.2015.33
Sclair SN, Little E, Levy C. Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis. Clin Transl Gastroenterol. 2015 Aug 27;6:e109. doi: 10.1038/ctg.2015.33. PMID: 26312413; PMCID: PMC4816277.
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Clin Transl Gastroenterol. 2015 Aug 27;6:e109. doi: 10.1038/ctg.2015.33.

Current Concepts in Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis.

Clinical and translational gastroenterology

Seth N Sclair, Ester Little, Cynthia Levy

Affiliations

  1. Schiff Center for Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida, USA.
  2. Banner University Medical Center, Phoenix, Arizona, USA.

PMID: 26312413 PMCID: PMC4816277 DOI: 10.1038/ctg.2015.33

Abstract

Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) are chronic, cholestatic diseases of the liver with common clinical manifestations. Early diagnosis and treatment of PBC slows progression and decreases the need for transplant. However, one-third of patients will progress regardless of treatment. Bilirubin <1.0 and alkaline phosphatase <2.0 x the upper limit of normal at 1 year after treatment appear to predict 10-year survival. Ursodeoxycholic acid (UDCA) is the recommended treatment for PBC, and recent studies with obeticholic acid showed promising results for UDCA non-responders. Unlike PBC, no therapy has been shown to alter the natural history of PSC. The recommended initial diagnostic test for PSC is magnetic resonance cholangiopancreatography, typically showing bile duct wall thickening, focal bile duct dilatation, and saccular dilatation of the intra- and/or extrahepatic bile ducts. Immunoglobulin 4-associated cholangitis must be excluded when considering the diagnosis of PSC, to allow for proper treatment, and monitoring of disease progression. In addition to the lack of therapy, PSC is a pre-malignant condition and close surveillance is indicated.

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