{"id":2317,"date":"2017-01-12T15:31:16","date_gmt":"2017-01-12T15:31:16","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/gaspsc\/"},"modified":"2026-03-10T19:45:36","modified_gmt":"2026-03-10T19:45:36","slug":"gaspsc","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/gaspsc\/","title":{"rendered":"Diagnostic Criteria of Primary Sclerosing Cholangitis (PSC)"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p>Primary sclerosing cholangitis (PSC) is a\u00a0chronic cholestatic liver disease of unknown cause that is\u00a0characterized pathologically by an inflammatory and\u00a0fibrotic process centered on the epithelium, leading to\u00a0diffuse biliary stenosis and increased wall thickness\u00a0throughout the intra- and extra-hepatic biliary trees.<br \/>\n<!--more--><br \/>\n<b>Diagnostic Criteria of Primary Sclerosing Cholangitis (PSC)<\/b><br \/>\nIt is necessary to exclude IgG4-related sclerosing cholangitis, secondary sclerosing\u00a0cholangitis caused by diseases with an obvious pathogenesis, and malignant diseases\u00a0such as biliary cancer.<br \/>\nA. Diagnostic items<br \/>\nI. Major items<br \/>\nA. Biliary tract imaging<br \/>\n1) Cholangiographic findings characteristic of PSC<br \/>\n2) Cholangiographic findings not specific to PSC<br \/>\nB. An increased alkaline phosphatase level<br \/>\nII. Minor items<br \/>\na. Association with inflammatory bowel disease<br \/>\nb. Liver histology:\u00a0Fibrous cholangitis\/onion skin lesion<br \/>\nB. Diagnosis<br \/>\nDefinite diagnosis<\/p>\n<ul>\n<li>A1) +B<\/li>\n<li>A1) +a<\/li>\n<li>A1) +b<\/li>\n<li>A2) +B+a+b<\/li>\n<\/ul>\n<p>Probable diagnosis<\/p>\n<ul>\n<li>A1)<\/li>\n<li>A2) +B+a<\/li>\n<li>A2) +B+b<\/li>\n<li>A2) +a+b<\/li>\n<\/ul>\n<p>Possible diagnosis<\/p>\n<div>\n<ul>\n<li>A2) +a<\/li>\n<li>A2) +b<\/li>\n<\/ul>\n<\/div>\n<div><\/div>\n<p><b>Lists of secondary sclerosing cholangitis<\/b><br \/>\nCongenital<\/p>\n<ul>\n<li>Caroli\u2019s disease<\/li>\n<li>Cystic fibrosis<\/li>\n<\/ul>\n<p>Chronic obstruction<\/p>\n<ul>\n<li>Choledocholithiasis<\/li>\n<li>Biliary stricutures (secondary to surgical trauma, chronic pancreatitis)<\/li>\n<li>Anastomotic stricutures in liver graft<\/li>\n<li>Neoplasmas (benign, malignant, metastatic)<\/li>\n<\/ul>\n<p>Infectious<\/p>\n<ul>\n<li>Bacterial cholangitis<\/li>\n<li>Recurrent pyogenic cholangitis<\/li>\n<li>Parastic infection (cryptosporidiosis, microsporidiosis)<\/li>\n<li>Cytomegalovirus infection<\/li>\n<\/ul>\n<p>Toxic<\/p>\n<ul>\n<li>Accidental alcohol, formaldehyde, hypertonic saline instillation in\u00a0the bile ducts<\/li>\n<\/ul>\n<p>Immunologic<\/p>\n<ul>\n<li>Eosinophilic cholangitis<\/li>\n<li>Acquired immunodeficiency<\/li>\n<\/ul>\n<p>Ischemic<\/p>\n<ul>\n<li>Vascular trauma<\/li>\n<li>Posttraumatic sclerosing cholangitis<\/li>\n<li>Post-transplantation hepatic artery thrombosis<\/li>\n<li>Hepatic allograft rejection (acute, chronic)<\/li>\n<li>Intra-arterial, chemotherapy-related injury<\/li>\n<li>Transcatheter arterial embolization therapy<\/li>\n<\/ul>\n<p>Infiltrative disorders<\/p>\n<ul>\n<li>Systemic vasculitis<\/li>\n<li>Amyloidosis<\/li>\n<li>Radiation injury<\/li>\n<li>Sarcoidosis<\/li>\n<li>Systemic mastocytosis<\/li>\n<li>Hypereosinophilic syndrome<\/li>\n<li>Hodgkin\u2019s disease<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p><b>References:<\/b><\/p>\n<ol>\n<li>Nakazawa T, Notohara K, Tazuma S, Tanaka A, Isayama H, Tsuyuguchi T, Mori T, Takikawa H. The 2016 diagnostic criteria for primary sclerosing cholangitis. J Gastroenterol. 2016 Dec 5.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27921168\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Lazaridis KN, LaRusso NF. Primary Sclerosing Cholangitis. N Engl J Med. 2016 Sep 22;375(12):1161-70.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/27653566\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Nakazawa T, Naitoh I, Hayashi K, Miyabe K, Simizu S, Joh T. Diagnosis of IgG4-related sclerosing cholangitis.\u00a0World J Gastroenterol. 2013 Nov 21;19(43):7661-70.\u00a0<a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/24282356\/\" target=\"_blank\" rel=\"noopener noreferrer\">[Medline]<\/a><\/li>\n<li>Svensson Di Giorgio S, Scandavini CM, Molinaro A, Arnelo U, Valente R. Primary Sclerosing Cholangitis: Diagnosis, Management, and Clinical Challenges. J Clin Med. 2026 Feb 2;15(3):1149. <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/41682828\/\" target=\"_blank\" rel=\"noopener\">[Medline]<\/a><\/li>\n<\/ol>\n<p>&nbsp;<\/p>\n<p>Created Jan 12, 2017.<br \/>\nUp-date Mar 10, 2026.<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[53],"tags":[661,376,375,16,15,14,13,660,282,114,659,662],"class_list":["post-2317","post","type-post","status-publish","format-standard","hentry","category-gastroenterology","tag-cep","tag-cholangitis","tag-colangitis","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-esclerosante","tag-primaria","tag-primary","tag-psc","tag-sclerosing"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2317","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2317"}],"version-history":[{"count":4,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2317\/revisions"}],"predecessor-version":[{"id":10693,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2317\/revisions\/10693"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2317"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2317"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2317"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}