The management of primary sclerosing cholangitis.

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 syst...

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Main Author: Chapman, R
Format: Journal article
Language:English
Published: 2003
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author Chapman, R
author_facet Chapman, R
author_sort Chapman, R
collection OXFORD
description 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.
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spelling oxford-uuid:26a8dcd0-36dc-43b6-970f-de2ba043384b2022-03-26T12:02:16ZThe management of primary sclerosing cholangitis.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:26a8dcd0-36dc-43b6-970f-de2ba043384bEnglishSymplectic Elements at Oxford2003Chapman, RPrimary 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.
spellingShingle Chapman, R
The management of primary sclerosing cholangitis.
title The management of primary sclerosing cholangitis.
title_full The management of primary sclerosing cholangitis.
title_fullStr The management of primary sclerosing cholangitis.
title_full_unstemmed The management of primary sclerosing cholangitis.
title_short The management of primary sclerosing cholangitis.
title_sort management of primary sclerosing cholangitis
work_keys_str_mv AT chapmanr themanagementofprimarysclerosingcholangitis
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