A 30-year-old man with ulcerative colitis presents with raised ALP (380 U/L), GGT 290 U/L, and mildly elevated bilirubin. AMA is negative. p-ANCA is

Question

A 30-year-old man with ulcerative colitis presents with raised ALP (380 U/L), GGT 290 U/L, and mildly elevated bilirubin. AMA is negative. p-ANCA is positive. MRCP shows multifocal intrahepatic and extrahepatic bile duct strictures with a beaded appearance. What is the most likely diagnosis?

Accepted Answer

Primary sclerosing cholangitis

Answer

Primary biliary cholangitis

Answer

Bone disease (Paget)

Answer

Cholestatic drug reaction

Answer

Biliary obstruction (gallstones)

Primary Sclerosing Cholangitis — RACP Adult Medicine MCQ

A 30-year-old man with ulcerative colitis presents with raised ALP (380 U/L), GGT 290 U/L, and mildly elevated bilirubin. AMA is negative. p-ANCA is positive. MRCP shows multifocal intrahepatic and extrahepatic bile duct strictures with a beaded appearance. What is the most likely diagnosis?