Primary sclerosing cholangitis vs biliary cholangitis

Both are autoimmune disease where the the bile ducts are affected.

 

Primary Sclerosing Cholangitis

• Intra and extra hepatic bile ducts are inflamed and damaged
• Strictures develop and sclerosis occurs 
• Chronic bile obstruction leads to hepatitis, fibrosis and cirrhosis
• Strong association with ulcerative colitis
• Autoantibodies are not useful in diagnosis or assessment. None are sensitive or specific
• Stent on ERCP for treatment

 

Primary Biliary Cholangitis 

• Intrahepatic bile ducts only
• Inflammation to epithelial cells of bile ducts can cause obstruction - cholestasis
• Anti-mitochondrial antibodies (AMA) are most specific and are part of diagnostic criteria
• Treatment with ursodeoxycholic acid - its a bile acid that makes the bile less harmful to the epithelial cells