Talk:Primary sclerosing cholangitis

Related diseases

In the introduction, a study is cited "...and more than 80% of those with PSC have ulcerative colitis.[2]", whereas in the section Related diseases, "...and approximately 70% of people with primary sclerosing cholangitis have ulcerative colitis.[3]". While I am not familiar with the cited work, there is an obvious inconsistency here.--Nocturnalnectar (talk) 10:26, 27 October 2013 (UTC)

Anon

80.139.115.208, you put more stuff into the intro. That's fine, but do keep in mind that everything you added is covered (in lay terms) later on in the article. I generally avoid discussions on the mechanisms of diseases in the intros, as many are still speculative. JFW | T@lk 22:51, 4 Aug 2004 (UTC)

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"Malabsorption (especially of fat) and steatorrhea, leading to decreased levels of the fat-soluble vitamins, A, D and K." Shouldn't this include vit E? 67.124.100.215 06:35, 9 May 2005 (UTC)

It can however also start with children.

Um, do you mean that it can start in childhood? Or that a mother, after having children, could come down with it? Something else? Please clarify. --Jacqui M Schedler 23:38, 31 August 2005 (UTC)

Added more on screening, role of ERCP for dominant strictures. -- Samir Grover 08:10, 26 January 2006 (UTC)

according to the most recent robbins textbook, autoantibodies are present in less than 10% of patients. i disagree, then, that primary sclerosing cholangitis is primarily caused by autoimmunity. —Preceding unsigned comment added by 67.167.1.6 (talk) 21:32, 29 September 2008 (UTC)

PSC support

Adding the PSC-Support group link back. Is there a specific reason for it's deletion previously? Do you dislike the site itself, or do you see a problem of some sort with the description? Just FYI it's not a commercial site (that is it's on yahoo, but the group itself doesn't try to sell anything), and it is more directly related to PSC than some other links that you've left. I did try to follow guidelines for adding the link, but I am a newbie here so if I did something wrong let me know and I'll try to fix it!

You didn't do anything wrong but I suspect the link may not be suitable. Yahoo groups (and any unauthoratitive online resource) are poor candidates for linking as per WP:EL. If you think the remaining links are not suitable, please point out which ones. JFW | T@lk 22:43, 12 June 2006 (UTC)

Case series

A very large case series from Germany: doi:10.1111/j.1572-0241.2006.00872.x JFW | T@lk 16:57, 11 March 2007 (UTC)

Epidemiology

Mikael Häggström (talk · contribs) added a single study that looked at the epidemiology of PSC. I suggested that a secondary source be used because a single study might skew the results depending on the population. Mikael then returned exactly the same data but with a source supporting its existence! This is not what I meant. The source (well done for finding it) also gives data from a Spanish study that strongly conflicts with the Norwegian data. I have now fully removed the Norwegian source and just cited everything to the Feld 2003 paper. It is available freely online. It might also be a useful source for some other content, such as disease associations. JFW | T@lk 11:47, 18 November 2010 (UTC)

Thanks for your improvement. Mikael Häggström (talk) 10:09, 20 November 2010 (UTC)

Antibody types

The section on antibodies states:

Approximately 80% of patients have perinuclear anti-neutrophil cytoplasmic antibodies, also called anti mitochondrial;

I was under the impression that ANCA and AMA were different, and in fact the page on ANCA doesn't mention anything about AMA, and vice versa, so I suspect this is wrong. Also, AMA is specific for primary biliary cholangiitis, which obviously is a different disease. I'm fairly sure this is the case. 82.47.78.34 (talk) 07:29, 21 September 2013 (UTC)

Case series with oral vancomycin

I recently came across a case series for oral vancomycin as treatment for PSC in children. I apologize since I'm new here and I don't know exactly what should be included on wiki pages. The series was published in 2008 (http://www.ncbi.nlm.nih.gov/pubmed/18607270) and is cited in at least one review article (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3629750/). The group is currently running a phase 3 clinical trial (http://clinicaltrials.gov/show/NCT01802073) though as I understand it this does NOT warrant mentioning on the page. I don't know if it's customary or possible to put a "current research" section somewhere, though I do think this could be useful information for someone looking for treatments. Stpoulos (talk) 17:25, 21 October 2013 (UTC)

Thanks Stpoulos. I think a secondary source is needed before we can discuss ongoing research even in a "research directions" section (see WP:MEDMOS for the background). Suruttama just added a long section but I don't believe we can say all this with sufficient confidence. Organisations such as http://www.childrenspsc.org/ seem to think that vancomycin is the next big thing but without scientific/statistical evidence I am concerned that we might be creating false hope if the trial ultimately fails to show a benefit.

The secondary source (Trivedi & Hirschfield) is in a low-impact journal although there is little doubt as to the authority of the authors. JFW | T@lk 20:37, 28 May 2014 (UTC)

Last year's Lancet review mentions several studies with antibiotics (doi:10.1016/S0140-6736(13)60096-3) but makes the point that the only endpoints in that study was blood tests and not progression of disease. JFW | T@lk 20:48, 28 May 2014 (UTC)

NEJM review

doi:10.1056/NEJMra1506330 JFW | T@lk 08:21, 22 September 2016 (UTC)

Lancet seminar

doi:10.1016/S0140-6736(18)30300-3 JFW | T@lk 21:15, 24 June 2018 (UTC)