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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 ... • Fatigue PBC
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
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
Sclerosing Cholangitis (PSC ... ) PSC is a chronic ... • COVERT - PSC ... patients with PSC ... • CANCER - PSC
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
Causes of Acute Liver Injury - Differential Diagnosis
Hepatocellular - Liver Parenchyma
 • Infectious: Hepatitis C, A,
Injury - Differential ... Malignancy, 1° PBC ... , 1° PSC, Cystic ... #Injury #Differential ... Acute #algorithm #hepatology
Primary Biliary Cirrhosis - Pathophysiology
Environmental Risk Factors: Geographic location, Smoking, Microbial triggers, Xenobiotics, Nail polish
Epigentics Risk
Primary Biliary ... Cirrhosis - Pathophysiology ... relative with PBC ... Cholestasis #PBC ... #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