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Last updated:May 2019
Cholestatic liver disease causing continued destruction of the bile ducts, cirrhosis, and end-stage liver disease.
Predominantly affects young and middle-aged men, often with underlying inflammatory bowel disease.
Patients may be asymptomatic at diagnosis but develop symptoms of pruritus and jaundice.
Diagnosis involves laboratory tests and cholangiography.
No effective medical therapy is available.
Liver transplantation is the only treatment option for patients with advanced disease.
Liver failure and cholangiocarcinoma are the leading causes of death.
Primary sclerosing cholangitis (PSC) is a chronic progressive cholestatic liver disease, characterised by inflammation and fibrosis of the intrahepatic and/or extrahepatic bile ducts, resulting in diffuse, multi-focal stricture formation. It is often associated with inflammatory bowel disease. Complications include dominant biliary strictures (focal areas of tight narrowing of the extrahepatic biliary tree that develops in 40% to 50% of patients as a result of progressive structuring), cholangitis, cholangiocarcinoma, and end-stage liver disease (due to chronic progressive biliary fibrosis).
male sex
history of inflammatory bowel disease
age in 40s or 50s
steatorrhoea
genetic predisposition
early disease
end-stage liver disease
S. Ian Gan, MD, FRCPC
Associate Clinical Professor
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 topic.
Marlyn Mayo, MD
Division of Digestive and Liver Diseases
University of Texas Southwestern Medical Center
MM is an author of a reference cited in this monograph.
James Neuberger, BM, BCh
Liver Unit
JN declares that he has no competing interests.
Secondary sclerosing cholangitis
Immunoglobulin G4 cholangitis
Autoimmune hepatitis
ACG clinical guideline: primary sclerosing cholangitis external link opens in a new window
Clinical diagnostic criteria of IgG4-related sclerosing cholangitis 2012 external link opens in a new window
MELDNa scores (for liver transplantation listing purposes, not appropriate for patients under age 12 years) (SI units)
Primary sclerosing cholangitis (PDF, 1 MB)external link opens in a new window


We invite all parishioners to the annual Parish Stewardship Dinner, featuring the Rev. David Marshall, Rector of St. Dunstan's Episcopal Church in Shoreline. The dinner, featuring simple and sustaining fare created by our own master chef, Ken Rhodes, will begin on Wednesday, November 14, at 6:00 PM in Puddicombe Hall. There is no charge for this wonderful event.
You can find out more about Rev. Marshall and the ministry and mission of St. Dunstan's here. Please join us for what promises to be an inspiring evening!
No one will be solicited for donations at this event. We will offer our pledges to St. Andrew's on Sunday, November 18, at both services.


Spiller Rancher spurs made for Kyle Lewis, Olney Tx.
These Spiller Cowboy shank spurs sold for $5,100 at the 2007 auction to benefit Women's Protective Service of Lubbock, Texas. They belong to Bill Masterson, JY Ranch, Guthrie, Texas.


We organise murder mysteries* for various events and parties. This experience allows you to travel into the fantasy world, where you can enjoy adventures that everyday life does not offer. You can solve the murder mysteries in the Middle Ages, in the 1920s and 1930s, as well as at a wedding. The thoroughly planned murders are elegant and spiced with mysteries. If you find murders too brutal, we can think of another subject for the game.
For an extra cost, you can order a photograph and rent costumes and accessories.
* All participants will (probably) be alive and well at the end of the game!