Sclerosing Cholangitis: Incorrect

Sclerosing cholangitis is a rare chronic disease of unknown cause characterized by nonbacterial inflammatory narrowing of the bile ducts. Interestingly, about 60% if cases occur in patients with ulcerative colitis. The disease predominately affects men aged 20-50. In most cases the entire biliary tree is affected with this inflammatory process causing irregular narrowing. Clinically, the patient usually complains of a gradual onset of jaundice and pruritus. Laboratory findings are typical of cholestasis. Serum bilirubin is typically around 4 mg/dL. The ERCP is usually diagnostic demonstrating the classic beads on a string appearance.

Mrs. Jones does not have sclerosing cholangitis. The acute nature of her symptoms makes it unlikely that she has a chronic inflammatory process or a tumor. In addition her LFTs are normal with the exception of a mildly elevated bilirubin typical of acute cholecystitis.

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