The duration of inflammatory bowel disease (IBD) is associated with an increased risk of cholangiocarcinoma in patients who also have primary sclerosing cholangitis, according to researchers at the Mayo Clinic in Rochester, Minnesota. Reuters Health Information

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Publication date: 23–29 June 2018Source: The Lancet, Volume 391, Issue 10139Author(s): Jessica K Dyson, Ulrich Beuers, David E J Jones, Ansgar W Lohse, Mark HudsonSummaryPrimary sclerosing cholangitis is a rare, chronic cholestatic liver disease characterised by intrahepatic or extrahepatic stricturing, or both, with bile duct fibrosis. Inflammation and fibrosis of bile ducts and the liver are followed by impaired bile formation or flow and progressive liver dysfunction. Patients might be asymptomatic at presentation or might have pruritus, fatigue, right upper quadrant pain, recurrent cholangitis, or sequelae of por…

Source: The LancetCategory: General Medicine Source Type: research

As we heard the history we stopped, prior to hearing the exam and labs, and developed a differential diagnosis.  With the combination of itching, probable jaundice and pale stools we assume either intrahepatic or extrahepatic obstruction.  Our differential diagnosis with commentary:
 

Primary biliary cirrhosis – much more common in women then men – but does often present at this age with uncontrollable itching
Primary sclerosing cholangitis – no history of ulcerative colitis or diarrhea symptoms, but still possible
Gallstone – not all common duct stones cause pain
Cholangiocarcinoma …

Source: DB’s Medical RantsCategory: Internal Medicine Authors: Tags: Medical Rants Source Type: blogs

Publication date: Available online 13 February 2018 Source:The Lancet Author(s): Jessica K Dyson, Ulrich Beuers, David E J Jones, Ansgar W Lohse, Mark Hudson Primary sclerosing cholangitis is a rare, chronic cholestatic liver disease characterised by intrahepatic or extrahepatic stricturing, or both, with bile duct fibrosis. Inflammation and fibrosis of bile ducts and the liver are followed by impaired bile formation or flow and progressive liver dysfunction. Patients might be asymptomatic at presentation or might have pruritus, fatigue, right upper quadrant pain, recurrent cholangitis, or sequelae of portal hypertension….

Source: The LancetCategory: General Medicine Source Type: research

Conclusion: This is the first reported case of hepatic ASC in a patient with PSC. Patients with PSC should be recognized as being at a risk of not only general cholangiocarcinoma, hepatocellular carcinoma, and metastatic liver tumor, but also ASC.Oncology 2017;93(suppl 1):76-80

Source: OncologyCategory: Cancer & Oncology Source Type: research

CONCLUSION: This is the first reported case of hepatic ASC in a patient with PSC. Patients with PSC should be recognized as being at a risk of not only general cholangiocarcinoma, hepatocellular carcinoma, and metastatic liver tumor, but also ASC.
PMID: 29258074 [PubMed – in process]

Source: OncologyCategory: Cancer & Oncology Authors: Tags: Oncology Source Type: research

Abstract
Primary sclerosing cholangitis (PSC) is a chronic, idiopathic biliary tract disease characterized by segmental strictures. The disease is progressive with no proven treatments and may eventually lead to cirrhosis and end-stage liver disease. Abrupt changes in liver biochemistries, pain, and/or cholangitis may suggest a dominant stricture amenable to endoscopic therapy or the development of cholangiocarcinoma. Patients with PSC are at increased risk of cholangiocarcinoma. There is a strong association with inflammatory bowel disease, and an associated increased risk of colorectal cancer. Colonoscopy every …

Source: Clinical Colorectal CancerCategory: Cancer & Oncology Authors: Tags: Clin Liver Dis Source Type: research

This article is part of a Special Issue entitled: Cholangiocytes in Health and Diseaseedited by Jesus Banales, Marco Marzioni, Nicholas LaRusso and Peter Jansen.

ConclusionsThis unselected population‐based study shows that PSC‐IBD patients not only have an extensive phenotype of IBD, they are also treated more intensively than other patients with IBD. However, the prognosis remains poor and without any apparent improvement over calendar time.This article is protected by copyright. All rights reserved.

Source: Liver InternationalCategory: Gastroenterology Authors: Tags: Original Article Source Type: research

Primary sclerosing cholangitis (PSC) is a rare disorder characterized by multi-focal bile duct strictures and progressive liver disease. Inflammatory bowel disease (IBD) is usually present and there is a high risk of cholangiocarcinoma and colorectal cancer. With no effective medical therapy, most patients ultimately require liver transplantation, after which disease recurrence may occur. With limited therapeutic options and lack of proven surveillance strategies, patients experience significant unmet needs.

Source: Journal of HepatologyCategory: Gastroenterology Authors: Tags: Seminar Source Type: research

Primary sclerosing cholangitis (PSC) is a chronic, idiopathic biliary tract disease characterized by segmental strictures. The disease is progressive with no proven treatments and may eventually lead to cirrhosis and end-stage liver disease. Abrupt changes in liver biochemistries, pain, and/or cholangitis may suggest a dominant stricture amenable to endoscopic therapy or the development of cholangiocarcinoma. Patients with PSC are at increased risk of cholangiocarcinoma. There is a strong association with inflammatory bowel disease, and an associated increased risk of colorectal cancer. Colonoscopy every 1 to 2  years is appropriate.

Source: Clinics in Liver DiseaseCategory: Gastroenterology Authors: Source Type: research





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