Archive for the ‘Inflammatory Disease’ Category
None of the currently available treatments for primary sclerosing cholangitis, has demonstrated a proven effect by modifying the natural history of disease.
The most common drug used is ursodeoxycholic acid, based primarily on the benefits of this bile acid in cholestatic diseases such as primary biliary cirrhosis. The use of this drug in doses up to 15 mg/kg has shown benefits biochemical (decrease of alkaline phosphatase [FA] and gamma glutamyl transpeptidase [GGT]), but has not shown clear benefits histological or survival of patients.
Prospective studies are ongoing using higher doses (20 to 30 mg/kg). A new derivative of ursodeoxycholic acid called ursodeoxycholic rules seems promising pre-clinical studies. Read the rest of this entry »
Among the manifestations of cholestasis associated with primary sclerosing cholangitis should be mentioned:
- Steatorrhea and fat-soluble vitamin deficiency: Decreased bile acid secretion into the intestine interferes with the absorption of fat soluble vitamins. Although frank diarrhea and steatorrhea are uncommon, deficiency of vitamin A, D, E and K are relatively common. The differential diagnosis of diarrhea are some conditions that are more common in patients with primary sclerosing cholangitis, such as chronic pancreatitis and celiac disease.
- Osteoporosis: sclerosing cholangitis, as primary biliary cirrhosis, is frequently associated with osteoporosis. The cause of osteoporosis is not completely clear, since vitamin D deficiency produces osteomalacia rather than osteoporosis. Patients with sclerosing cholangitis have an increased risk of fractures, particularly those patients who have undergone liver transplantation. Read the rest of this entry »
Primary sclerosing cholangitis is a progressive inflammatory disease of the bile ducts. The disease usually associated with ulcerative colitis: Up to 90% of patients with primary sclerosing cholangitis with ulcerative colitis. Less frequently may be associated with Crohn’s disease. On the other hand, the prevalence of sclerosing cholangitis in patients with ulcerative colitis is approximately 5%. It is a disease that predominantly affects men (only 30% of sufferers are women).
Primary sclerosing cholangitis is often asymptomatic in the early stages of the disease. May be suspected in front of the finding of alterations in liver enzymes in patients with ulcerative colitis, particularly elevation of alkaline phosphatases. Pruritus and fatigue can be symptoms of presentation in some cases. 10 to 15% of patients present with fever, jaundice and right upper quadrant abdominal pain, which is explained by recurrent episodes of cholangitis. Read the rest of this entry »