Primary Sclerosing Cholangitis

It’s often found by accident while testing for something else. Up to 50% of people may not have any symptoms at the time of diagnosis. Early signs of the disease may show up on a blood test or imaging test. Images of bile ducts with PSC show certain distinctive features. A blood test may show high levels of alkaline phosphatase or certain antibodies that indicate an immune response in your bile ducts. White blood cell elevation is usually a sign of infection in the liver.

To confirm the disease, your healthcare provider may suggest a more specific test, such as a:

• Liver function test. These blood tests look for high levels of particular liver enzymes. High levels of alkaline phosphatase may indicate PSC.
• Magnetic resonance cholangiopancreatography (MRCP). This test uses magnetic resonance imaging (MRI) to produce detailed pictures of the biliary tree (your liver, gallbladder and bile ducts). This is the first-line imaging test for PSC because it’s non-invasive and avoids radiation exposure. Occasionally, it might not reveal an early or mild case of the disease, and you might need another kind of imaging test.