Our Summer meeting was well attended, with PSCers coming from as far as Scotland, Wales, Cornwall and Kent. This was the first time we’d asked people to pre-register, and it worked well, allowing us to have badges ready for everyone, send reminders/directions and have the guess-work taken out of catering numbers. New friendships were struck with a good mix of old and new faces. We’ve added some of the photos to our website. It was a super day. Thank you all for coming and we hope to see you again in Birmingham!
Exciting times ahead
Dr Chapman began by saying what an exciting time it is for PSC, which is sometimes referred to as the ‘last black hole in hepatology’ meaning that there are a lot more questions than answers. However, over the last two years, there has been more research activity than ever before and more money being put into PSC research, particularly in Europe and America, with PSC research taking on a new lease of life. With this increased interest in PSC comes the hope of new treatments, which is what we’re all about.
What is PSC?
Dr Chapman reminded us about the condition, showing an MRCP image of the narrowing bile ducts, which, over a 15-20 year period, causes scaring and damage to the liver.
Diagnosis in 2012
Diagnosis in 2012 has changed a lot in the last few years, with PSC most often being detected upon noticing abnormal Liver Function Tests during routine inflammatory bowel screening and monitoring. This means PSC is now diagnosed much earlier than in previous years.
He discussed current diagnostic tests:
- Abnormal liver function tests
- Blood antibody ANCA present (but not diagnostic)
- IgG4 - PSC patients should have IgG4 measured to exclude IgG4 sclerosing cholangitis. A Welcome grant is currently funding research into IgG4-sclerosing cholangitis, which is believed to be a separate disease with different treatment from PSC.
- Cholangiogram (usually MRCP).
- Liver biopsy (rarely conducted now – only in cases such as small duct PSC or Autoimmune Hepatitis overlap.)
MRCP is the first choice for cholangiogram in the UK for diagnosing suspected PSC. Dr Chapman praised the skill of the radiologist Dr Bungay at the John Radcliffe hospital, who has made some valuable observations about PSC and MRCP. It is less invasive than ERCP. In some parts of Europe, the ERCP is still used for diagnosis.