Primary Biliary Cholangitis vs Primary Sclerosing Cholangitis
Primary Biliary Cholangitis and Primary Sclerosing Cholangitis are easy to mix up on the boards. Here's a side-by-side comparison — presentation, workup, imaging, and first-line treatment — drawn from our full outlines.
Primary Biliary Cholangitis vs Primary Sclerosing Cholangitis at a glance
- Primary Biliary Cholangitis: Autoimmune destruction of small intrahepatic bile ducts → cholestasis, pruritus, fatigue; AMA-positive in 95%.
- Primary Sclerosing Cholangitis: Chronic fibroinflammatory disease of intra- and extrahepatic bile ducts → strictures and biliary cirrhosis; strong IBD link.
Keep comparing — start your free trial
You've used your 2 free previews. Create your free account to see the full Primary Biliary Cholangitis vs Primary Sclerosing Cholangitis comparison — plus all 514 diagnosis outlines, 5,500+ board-style questions, and an AI tutor. Your 7-day free trial includes everything, no credit card required.
Side-by-side comparison
| Feature | Primary Biliary Cholangitis | Primary Sclerosing Cholangitis |
|---|---|---|
| At a glance | Autoimmune destruction of small intrahepatic bile ducts → cholestasis, pruritus, fatigue; AMA-positive in 95%. | Chronic fibroinflammatory disease of intra- and extrahepatic bile ducts → strictures and biliary cirrhosis; strong IBD link. |
| Classic presentation | Middle-aged woman with fatigue, pruritus, and isolated alkaline phosphatase elevation — check AMA.; Often asymptomatic at diagnosis (incidental cholestatic… | Young man with ulcerative colitis and an elevated alkaline phosphatase — get an MRCP.; Often asymptomatic at diagnosis (~50%) — found via incidental… |
| Workup / key labs | 2 of 3: (1) cholestatic biochemistry (elevated alkaline phosphatase ≥1.5× ULN >6 months), (2) AMA positive (≥1:40) or PBC-specific ANA, (3) liver biopsy… | Characteristic MRCP/ERCP findings + cholestatic LFTs + exclusion of secondary causes. Small-duct PSC requires biopsy with cholestatic biochemistry and IBD.;… |
| Imaging | Abdominal ultrasound — exclude biliary obstruction; nonspecific for PBC; MRCP — typically normal in PBC (distinguishes from PSC, which shows beading) | Magnetic resonance cholangiopancreatography (MRCP) — first-line diagnostic test; demonstrates multifocal intra- and extrahepatic strictures with alternating… |
| First-line treatment | Ursodeoxycholic acid (UDCA) 13-15 mg/kg/day in divided doses — first-line for all PBC patients; improves transplant-free survival; Assess biochemical response… | No proven disease-modifying medical therapy; Ursodeoxycholic acid (UDCA) — improves biochemistry but no proven survival benefit; high-dose (28-30 mg/kg/day)… |
Drill Primary Biliary Cholangitis vs Primary Sclerosing Cholangitis questions on FirstPassPA
Turn this comparison into retention. 5,500+ board-style questions with an AI tutor that explains every answer — free to start, no card required.
Start studying free → Try today's free questionEducational use only. This outline is a study aid for PA students and is not medical advice or a substitute for clinical judgment. FirstPassPA is an independent study tool and is not affiliated with, endorsed by, or sponsored by NCCPA. PANCE® and PANRE® are registered trademarks of the National Commission on Certification of Physician Assistants.