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Cholestatic Liver Disease: Primary Biliary Cirrhosis vs Primary Sclerosing Cholangitis

#pathophysiology #pbc #psc #hepatology #comparison
Cholestatic Liver ... Disease: Primary ... Biliary Cirrhosis ... pathophysiology #pbc ... #psc #hepatology
Abnormal Liver Function Tests - Differential Diagnosis Algorithm for Transaminitis
Hepatocellular Pattern (ALT or AST > ALP):
Abnormal Liver Function ... Tests - Differential ... Ducts - PBC ... , PSC, Alcoholic ... Biliary stricture, PSC
Primary Biliary Cirrhosis (PBC) - Summary

PBC Epidemiology:
 • Female:Male 9:1
 • Common European descent
 • Age:
Cirrhosis (PBC) ... - Summary PBC ... 30-65 years PBC ... PBC Signs and ... bile ducts Differential
Primary Biliary Cirrhosis - Diagnosis Algorithm
Symptoms: Fatigue, Pruritus, Right upper quadrant discomfort
Signs: Jaundice, Xanthelasmata, Hepatomegaly
Associated history:
Primary Biliary ... pregnancy Diagnose PBC ... Liver biopsy findings ... consistent with PBC ... #PBC #Primary
Acute Liver Injury - Differential Diagnosis Algorithm

Vascular Causes of Acute Liver Injury: 
 • Hepatic vein:
Autoimmune hepatitis, PBC ... , PSC, IgG4, HLH ... stone, Malignancy, PBC ... , PSC, Cystic fibrosis ... hepatitis: < 1 • Cirrhosis
Alkaline Phosphatase (ALP) Elevation - Differential Diagnosis Algorithm

ALP:
 - Enzymes that catalyze hydrolysis of organic phosphate
ALP) Elevation - Differential ... Highest • Bone • Liver ... - Drugs - Primary ... biliary Cholangitis (PBC ... - PSC - Other
The 6 C’s of Primary Sclerosing Cholangitis (PSC)
PSC is a chronic, cholestatic, immune-mediated disease characterized by
The 6 C’s of Primary ... • CIRRHOSIS - ... indications for liver ... #Primary #Sclerosing ... management #summary #Hepatology
Autoantibodies and their Disease Associations
ANA - Non-specific; common in SLE, autoimmune hepatitis
Anti-CCP, Rheumatoid factor - RA
Anti-dsDNA
Dermatomyositis Anti-LKM (liver ... , Anti-gp210 - Primary ... biliary cirrhosis ... (PBC) Anticentromere ... Endomyseal antibody (EMA
Hemolysis - Differential Diagnosis Framework

1) Environment
  - Fragmentation
  - MAHA: TTP, HUS, DIC, HELLP
HELLP - Grafts, Valves ... Drug-associated, PCH ... Defects, Drugs, Liver ... Blood Smear ↑ abnormal ... #Diagnosis #hematology
Elevated Liver Enzymes - Differential Diagnosis Algorithm
Severe ALT > 15x ULN
 • Viral
 • Drugs/Toxins
 •
Elevated Liver Enzymes ... - Differential ... • Cholestatic disease ... Ducts • PSC ... Infiltrative • Cirrhosis