Ulcerative Colitis: The Daily PANCE Blueprint

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Ulcerative Colitis: The Daily PANCE Blueprint

A 26-year-old woman has 6 weeks of bloody diarrhea and tenesmus with continuous rectum-up colonic inflammation and mucosal crypt abscesses consistent with ulcerative colitis, and now has a cholestatic liver panel. Which associated condition is most likely?

A. Primary biliary cholangitis
B. Primary sclerosing cholangitis
C. Autoimmune hepatitis
D. Hereditary hemochromatosis
E. Gilbert syndrome

Answer and topic summary

The answer is B. Primary sclerosing cholangitis.

Ulcerative colitis is strongly associated with primary sclerosing cholangitis (PSC) – a cholestatic disease of the intra- and extrahepatic bile ducts (‘beads-on-a-string’ on MRCP) that raises the risk of cholangiocarcinoma and colorectal cancer. Primary biliary cholangitis (antimitochondrial-antibody positive) ties to other autoimmune conditions rather than UC; autoimmune hepatitis is hepatocellular; hemochromatosis is iron overload; and Gilbert syndrome is a benign unconjugated hyperbilirubinemia.

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Covered under ⇒ PANCE Blueprint GI and Nutrition ⇒ Colorectal Disorders ⇒ Inflammatory Bowel Disease

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