Current Gastroenterology Reports

, Volume 5, Issue 1, pp 9–17 | Cite as

The management of primary sclerosing cholangitis

  • Roger W. Chapman
Article

Abstract

Primary sclerosing cholangitis (PSC) is a chronic cholestatic hepatobiliary disease that usually progresses to biliary cirrhosis and liver failure; it also predisposes to cholangiocarcinoma. The cause of PSC is unknown, although evidence suggests that the tissue damage is mediated by the immune system. There is an unexplained close association between PSC and inflammatory bowel disease, particularly in ulcerative colitis, which coexists in the majority of patients with PSC. No medical therapy has been proven to halt or reverse disease progression; however, recent preliminary evidence suggests that ursodeoxycholic acid (UDCA) in a high dose of 20 to 25 mg/kg may slow the disease process. Evidence from a pilot study suggests that the combination of UDCA and immunosuppressive therapy, such as prednisolone or azathioprine, may also increase efficacy. For patients with end-stage PSC, liver transplantation remains the only effective therapy, although there is clear evidence that PSC may recur in the liver allograft.

Keywords

Bile Acid Cholangiocarcinoma Primary Biliary Cirrhosis Primary Sclerosing Cholangitis Orthotopic Liver Transplantation 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Current Science Inc. 2003

Authors and Affiliations

  • Roger W. Chapman
    • 1
  1. 1.Department of Hepatology and GastroenterologyOxford Radcliffe HospitalOxfordUK

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