Immune Diseases of the Liver

Answer B

PBC and PSC are both immunologic disorders. Approximately 20% of patients are ANA positive. Although PSC involves large bile ducts, they are usually fibrotic and do not dilate to any significant degree. Both disorders are associated with malignancies; PBC with breast carcinoma and PSC with cholangiocarcinoma and colon cancer. URSO has been shown to be beneficial in PBC and typiclly leads to a reduction in AST, ALT and ALP, improves liver histology in patients with stage I and II disease and reduces mortality and the need for liver transplantation in patients with cirrhosis. In contrast, two randomized controlled trials have not demonstrated any benefit in biochemistry, liver histology or mortality in patients with PSC.

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