Primary sclerosing cholangitis laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Dima Nimri, M.D. [2]

Laboratory Findings

The workup in patients with primary sclerosing cholangitis consists of LFTs, serum immunoglobulins, as well as a number of autoantibodies. Patients with primary sclerosing cholangitis typically have an elevated level of ALP, amongst other findings. However, laboratory results in many patients may be normal.

Liver Function Tests

Primary sclerosing cholangitis typically has a cholestatic clinical picture with elevation of ALP, and aminotransferases (AST and ALT) may be elevated to 2-3 times of the upper normal level. However, LFTs may be normal.

Immunoglobulins

• Hypergammaglobulinemia
• Elevated IgM levels
• Elevated IgG4 levels

Autoantibodies and Serology

One or more of the following autoantibodies may be present in patients with primary sclerosing cholangitis:

• Anti-neutrophil cytoplasmic antibody (p-ANCA)
• Anti-nuclear antibody (ANA)
• Anti-smooth muscle antibody (Anti-Sm)
• Anti-endothelial antibody
• Anti-cardiolipin antibody
• Thyroperoxidase
• Thyroglobulin
• Rheumatoid factor (RF)