Re: Recently Diagnosed

[Guest guest]

Dear " grammymc2003 " ;

> For 5 years I have had symptoms of PBC but the biopsy could never

> prove it one way or another.

In your initial diagnosis of " PBC " , did your doctor measure any serum

antibodies? The reason I ask is that PBC is usually associated with a

distinct antibody pattern .... usually anti-mitochondrial antibodies

directed against enzymes called dehydrogenases, and occassionally

against carbonic anhydrase.

> The ERCP biopsy and exam showed nothing

> in the bile ducts...clear...no cancer. I guess I need more

> explanation from the doctor because I thought both PBC and PSC were

> diseases of the bile ducts?

It is possible that your doctor might suspect " small-duct PSC " , which

might not show up as well on ERCP as would large-duct PSC.

> Can anyone tell me what to expect with this disease?

If it is small-duct PSC the course of the disease may be slower.

The following is taken from an article by Ortiz Zein, MD and

D Lindor, MD, Best Practice of Medicine. Last modified February

15, 2002.

Chronic Cholestatic Liver Disease in Adults:

Primary Sclerosing Cholangitis

Small Duct Primary Sclerosing Cholangitis

Isolated small duct PSC is diagnosed in patients with biochemical

features of cholestasis who have IBD and a liver biopsy showing

typical findings of PSC, but a normal cholangiogram. In some

patients, this appears to be an initial phase of PSC. Reported cases

suggest that small duct PSC is slowly progressive and that its course

resembles that of the large duct [59]. No information is available

regarding effective therapy for small duct PSC.

Links to this article, and many others, can be found at the following

URL:

http://home.insightbb.com/~rhodesdavid/

Do you also have inflammatory bowel disease (IBD) such as ulcerative

colitis or Crohn's disease? This is more common in PSC than in PBC.

I wish you all the best with your upcoming biopsy, and I hope that

this leads to a more definitive diagnosis for you.

Best regards,

Dave