Summary
Definición
Anamnesis y examen
Principales factores de diagnóstico
- male sex
- history of inflammatory bowel disease
Otros factores de diagnóstico
- age 25 to 45 years
- abdominal pain
- pruritus
- fatigue
- weight loss
- fever
- jaundice
- steatorrhea
- splenomegaly
- ascites
- encephalopathy
Factores de riesgo
- male sex
- inflammatory bowel disease (IBD)
- genetic predisposition
Pruebas diagnósticas
Primeras pruebas diagnósticas para solicitar
- serum alkaline phosphatase
- serum gamma-GT
- serum aminotransferases (aspartate aminotransferase, alanine aminotransferase)
- serum total bilirubin
- serum albumin
- CBC
- prothrombin time
- abdominal ultrasound
- magnetic resonance cholangiopancreatography (MRCP)
- serum IgG4
Pruebas diagnósticas que deben considerarse
- endoscopic retrograde cholangiopancreatography (ERCP)
- serum immunoglobulins
- 24 hour urine copper concentration
- ceruloplasmin
- antinuclear antibody
- anti-smooth muscle antibody
- antimitochondrial antibody
- abdominal CT scan
- liver biopsy
- bone mineral density scan
- colonoscopy
Algoritmo de tratamiento
early disease
end-stage liver disease
Colaboradores
Autores
S. Ian Gan, MD, FRCPC
Associate Clinical Professor
Vancouver General Hospital
University of British Columbia
Vancouver
BC
Divulgaciones
SIG declares that he has no competing interests.
Nawaf Tareq Aboalfaraj, MBBS, FRCPC
Gastroenterology Fellow
Vancouver General Hospital
University of British Columbia
Vancouver
BC
Divulgaciones
NTA declares that he has no competing interests.
Agradecimientos
Dr S. Ian Gan and Dr Nawaf Tareq Aboalfaraj would like to gratefully acknowledge Dr Kris V. Kowdley and Dr Christine Schlenker, the previous contributors to this topic.
Divulgaciones
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.
Revisores por pares
Marlyn Mayo, MD
Associate Professor of Medicine
Division of Digestive and Liver Diseases
University of Texas Southwestern Medical Center
Dallas
TX
Divulgaciones
MM is an author of a reference cited in this topic.
James Neuberger, BM, BCh
Consultant Physician
Liver Unit
Queen Elizabeth Hospital
Birmingham
UK
Divulgaciones
JN declares that he has no competing interests.
Diferenciales
- Secondary sclerosing cholangitis
- Immunoglobulin G4 cholangitis
- Autoimmune hepatitis
Más DiferencialesGuías de práctica clínica
- ACR Appropriateness Criteria: abnormal liver function tests
- EASL clinical practice guidelines on sclerosing cholangitis
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