Primary sclerosing cholangitis secondary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include screening for complications of [[liver cirrhosis]], screening for [[colon]] and [[gallbladder]] [[cancers]], as well as metabolic bone disease. | |||
==Secondary Prevention== | ==Secondary Prevention== | ||
Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include: | Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include:<ref name="pmid27653566">{{cite journal |vauthors=Lazaridis KN, LaRusso NF |title=Primary Sclerosing Cholangitis |journal=N. Engl. J. Med. |volume=375 |issue=12 |pages=1161–70 |year=2016 |pmid=27653566 |doi=10.1056/NEJMra1506330 |url=}}</ref><ref name="pmid20101749">{{cite journal |vauthors=Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ |title=Diagnosis and management of primary sclerosing cholangitis |journal=Hepatology |volume=51 |issue=2 |pages=660–78 |year=2010 |pmid=20101749 |doi=10.1002/hep.23294 |url=}}</ref><ref name="pmid27330336">{{cite journal |vauthors=Kumar A, Wheatley D, Puttanna A |title=Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management |journal=Clin Med Insights Gastroenterol |volume=9 |issue= |pages=25–9 |year=2016 |pmid=27330336 |pmc=4902039 |doi=10.4137/CGast.S38451 |url=}}</ref> | ||
<small></small> | |||
{| class="wikitable" | {| class="wikitable" | ||
!Complications/ Coexisting | ! align="center" style="background: #4479BA; color: #FFFFFF; " |Complications/ Coexisting Conditions | ||
!Presentation | ! align="center" style="background: #4479BA; color: #FFFFFF; " |Presentation | ||
!Screening | ! align="center" style="background: #4479BA; color: #FFFFFF; " |Screening | ||
!Management | ! align="center" style="background: #4479BA; color: #FFFFFF; " |Management | ||
|- | |- | ||
|[[Liver Cirrhosis]] | | style="background:#DCDCDC;" |[[Liver Cirrhosis]] | ||
| | | | ||
* [[Esophageal varices]], [[gastric varices]] | * [[Esophageal varices]], [[gastric varices]] | ||
| Line 24: | Line 26: | ||
* [[HCC]]: [[HCC]] is treated with [[ablation]], [[resection]] or [[liver transplantation]]. | * [[HCC]]: [[HCC]] is treated with [[ablation]], [[resection]] or [[liver transplantation]]. | ||
|- | |- | ||
| style="background:#DCDCDC;" |[[Gallbladder]] disease | |||
| | | | ||
* [[Polyps]]/ masses | |||
| | | | ||
* [[Abdominal]] [[ultrasound]] | |||
| | | | ||
* Consider prophylactic [[cholecystectomy]] in patients with [[gallbladder]] [[polyps]] and masses, due to high risk of [[carcinoma]]. | |||
* [[Chemotherapy]] is added if there is evidence of [[gallbladder]] [[cancer]] extending beyond the wall of the [[gallbladder]]. | |||
|- | |||
| style="background:#DCDCDC;" |[[IBD]] and associated risk of [[colon cancer]] | |||
| | |||
* [[Colon cancer]] | |||
| | |||
* [[Colonoscopy]] annually | |||
| | | | ||
* In case of [[colon cancer]], treat with [[colectomy]]. | |||
* [[Chemotherapy]] is added to treatment regimen according to guidelines of the treatment of [[colon cancer]]. | |||
|- | |- | ||
| style="background:#DCDCDC;" |Metabolic bone disease | |||
| | | | ||
* [[Osteopenia]]/ [[osteoporosis]] | |||
| | | | ||
* [[DEXA scan]]. Repeat every 2-3 years. | |||
| | | | ||
* For [[osteopenia]] and [[osteoporosis]], treat with [[calcium]] 1.0-1.5 g/day and [[vitamin D]] of 1,000 IU/day. | |||
|} | * Add [[bisphosphonates]] in the case of [[osteoporosis]]. | ||
|}<small> | |||
==References== | |||
{{reflist|2}} | {{reflist|2}} | ||
{{WS}} | {{WS}} | ||
{{WH}} | {{WH}}<small> | ||
Latest revision as of 17:27, 6 December 2017
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Primary sclerosing cholangitis Microchapters |
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Differentiating Primary sclerosing cholangitis from other Diseases |
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Primary sclerosing cholangitis secondary prevention On the Web |
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Risk calculators and risk factors for Primary sclerosing cholangitis secondary prevention |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]
Overview
Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include screening for complications of liver cirrhosis, screening for colon and gallbladder cancers, as well as metabolic bone disease.
Secondary Prevention
Secondary prevention in patients with primary sclerosing cholangitis is aimed at screening for complications and coexisting conditions in these patients. These include:[1][2][3]
| Complications/ Coexisting Conditions | Presentation | Screening | Management |
|---|---|---|---|
| Liver Cirrhosis |
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| Gallbladder disease |
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| |
| IBD and associated risk of colon cancer |
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| Metabolic bone disease |
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References
- ↑ Lazaridis KN, LaRusso NF (2016). "Primary Sclerosing Cholangitis". N. Engl. J. Med. 375 (12): 1161–70. doi:10.1056/NEJMra1506330. PMID 27653566.
- ↑ Chapman R, Fevery J, Kalloo A, Nagorney DM, Boberg KM, Shneider B, Gores GJ (2010). "Diagnosis and management of primary sclerosing cholangitis". Hepatology. 51 (2): 660–78. doi:10.1002/hep.23294. PMID 20101749.
- ↑ Kumar A, Wheatley D, Puttanna A (2016). "Primary Sclerosing Cholangitis: Therapeutic Options and Surveillance Management". Clin Med Insights Gastroenterol. 9: 25–9. doi:10.4137/CGast.S38451. PMC 4902039. PMID 27330336.