Summary
Definition
History and exam
Other diagnostic factors
- age in 40s or 50s
- abdominal pain
- pruritus
- fatigue
- weight loss
- fever
- jaundice
- steatorrhoea
- splenomegaly
- ascites
- encephalopathy
Diagnostic investigations
1st investigations to order
- serum alkaline phosphatase
- serum gamma-GT
- serum aminotransferases (AST, ALT)
- serum total bilirubin
- serum albumin
- FBC
- prothrombin time
- atypical antineutrophil cytoplasmic auto-antibody (ANCA)
- antimitochondrial antibody
- abdominal ultrasound
- MRCP
- ERCP
Investigations to consider
- serum immunoglobulins
- serum IgG4
- hepatic copper concentration
- urine copper concentration
- ceruloplasmin
- ANA
- anti-smooth muscle antibody
- abdominal CT scan
- liver biopsy
- bone mineral density scan
- colonoscopy
Treatment algorithm
Contributors
Authors VIEW ALL
Director of Education
Digestive Disease Institute
Virginia Mason Medical Center
Seattle
WA
Disclosures
SIG declares that he has no competing interests.
Dr S. Ian Gan would like to gratefully acknowledge Dr Kris V. Kowdley and Dr Christine Schlenker, the previous contributors to this monograph. KVK is a member of the speakers bureau of Axcan Pharma, manufacturer of Urso250 and Urso Forte, and gives one or two lectures a year on treatment of cholestatic liver diseases. KVK has also received funding from the NIH for a research study of Urso in PSC. CS declares that she has no competing interests.
Peer reviewers VIEW ALL
Associate Professor of Medicine
Division of Digestive and Liver Diseases
University of Texas Southwestern Medical Center
Dallas
TX
Disclosures
MM is an author of a reference cited in this monograph.
Consultant Physician
Liver Unit
Queen Elizabeth Hospital
Birmingham
UK
Disclosures
JN declares that he has no competing interests.
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