True regarding primary sclerosing cholangitis associated with ulcerative colitis are all of the following except: March 2007
Ans. D: Primary Sclerosing Cholangitis resolves after total colectomy Primary sclerosing cholangitis (PSC) is a form of cholangitis due to an autoimmune reaction. Primary sclerosing cholangitis leads to cholestasis. Blockage of the bile duct leads to accumulation of bile, which damages the liver, leading to jaundice and eventually causes liver failure. Signs and symptoms Tiredness (a non-specific symptom often present in liver disease) Severe jaundice with intense itching. Malabsorption (especially of fat) and steatorrhea, leading to decreased levels of the fat-soluble vitamins, A, D, E and K. Signs of cirrhosis Ascending cholangitis? The diagnosis is by imaging of the bile duct, usually in the setting of endoscopic retrograde cholangiopancreatography, which shows characteristic changes ("beading") of the bile ducts. Another option is magnetic resonance cholangiopancreatography (MRCP). The differential diagnosis can include primary biliary cirrhosis, drug induced cholestasis, cholangiocarcinoma, and HIV-associated cholangiopathy. PSC is often listed as a manifestation of ulcerative colitis outside the colon. PSC differs from these manifestations in that, unlike most other manifestations, PSC continues in spite of surgical removal of the colon. Standard treatment includes ursodiol. Treatment also includes medication to relieve itching (antipruritics) and bile acid sequesterants (cholestyramine) etc.
Biliary Cirrhosis is a known complication
Increased risk of hilar cholangiocarcinoma
May have raised levels of alkaline phoshphatase
Primary Sclerosing Cholangitis resolves after total colectomy