What is the association of primary sclerosing cholangitis?

Primary sclerosing cholangitis (PSC) is a cholestatic liver disease characterized by progressive inflammation and scarring of the bile ducts. The key association with PSC is inflammatory bowel disease (IBD), particularly ulcerative colitis. Studies have shown that a significant number of patients with PSC also have IBD, and this association suggests a possible shared autoimmune mechanism or genetic predisposition between these conditions.

Patients with PSC can present with symptoms such as jaundice, fatigue, and pruritus, and the liver function tests typically reveal an elevated alkaline phosphatase level. The overlapping occurrence of IBD and PSC indicates that monitoring for liver disease is crucial in patients diagnosed with IBD, as they are at increased risk for developing PSC.

The connections between PSC and other conditions like chronic alcoholic abuse, diabetes mellitus, or chronic viral hepatitis are much less established. These conditions do not share the same strong correlation with PSC as IBD does, which is why the association with inflammatory bowel disease is the most recognized and significant in clinical practice.