Sclerosing cholangitis refers to swelling (inflammation), scarring, and destruction of the bile ducts inside and outside of the liver.
Primary sclerosing cholangitis; PSC
Causes, incidence, and risk factors
The cause of this condition is usually unknown.
The disease may be seen in patients who have:
Genetic factors may also be responsible. Sclerosing cholangitis occurs more often in men than women. This disorder is rare in children.
Sclerosing cholangitis may also be caused by:
- Infections in the liver, gallbladder, and bile ducts
Signs and tests
Some people do not have symptoms, but blood work shows that they have abnormal liver function. The doctor will look for:
- Diseases that cause similar problems
- Diseases that often occur with this condition (especially inflammatory bowel disease)
Tests that show cholangitis include:
- Abdominal CT scan
- Abdominal ultrasound
- Endoscopic retrograde cholangiopancreatography (ERCP)
- Liver biopsy
- Magnetic resonance cholangiopancreatography (MRCP)
- Percutaneous transhepatic cholangiogram (PTC)
Blood tests include:
- Liver enzymes (liver function tests)
Medications that may be used include:
- Ursodeoxycholic acid (ursodiol)
- Fat-soluble vitamins (D, E, A, K)
- Antibiotics for infections in the bile ducts
- Medications that quiet the immune system (prednisone, azathioprine, cyclosporine, methotrexate)
How well patients do varies. The disease tends to get worse over time and sometimes patients develop:
- Biliary cirrhosis
- Liver failure
- Persistent jaundice
Some patients develop infections of the bile ducts that keep returning.
People with this condition have an increased risk of developing cancer of the bile ducts (cholangiocarcinoma). They should be checked regularly with a liver imaging test and blood tests.
Gordon FD. Primary sclerosing cholangitis. Surg Clin North Am. 2008;88:1385-1407.
Ross AS, Kowdley KV. Sclerosing cholangitis and recurrent pyogenic cholangitis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 68.