Discover and read the best of Twitter Threads about #ibdalgorithmmaster
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@MondayNightIBD @SobiaMujtabaMD @NabilQuraishi @CholestasisDoc @DCharabaty 1/ 35 y/o M presents with fatigue & generalized pruritus x 6weeks. No skin rash, No abdo pain, diarrhea or 🩸 in stool. AST 62 ALT 64 ALP 435 Tbili 1.3. MRI/MRCP: multifocal strictures & areas of dilatation of intra +extra hepatic ducts. What’s the next step?💡 #Back2Basics #B2B
@MondayNightIBD @SobiaMujtabaMD @NabilQuraishi @CholestasisDoc @DCharabaty 2/ What’s #PSC & phenotypes?
🧩Idiopathic chronic inflam dis. of the biliary tree
🧩90%: Large ducts (LD): "Beads on string appearance” on ERCP/MRCP (pt👆)
🧩5% Small IHD only: nml MRCP, dx by liver bx, slide👇
🧩5% PSC w AIH overlap: abnl MRCP+liver bx w⬆️AST/ALT or IgG
🧩Idiopathic chronic inflam dis. of the biliary tree
🧩90%: Large ducts (LD): "Beads on string appearance” on ERCP/MRCP (pt👆)
🧩5% Small IHD only: nml MRCP, dx by liver bx, slide👇
🧩5% PSC w AIH overlap: abnl MRCP+liver bx w⬆️AST/ALT or IgG
@MondayNightIBD @SobiaMujtabaMD @NabilQuraishi @CholestasisDoc @DCharabaty 3/ 💎#B2BPearl #PSC w ⬆️IgG4
📌15% of LD-PSC
📌⬆️IgG4 serum>140mg/dL +/- tissue
💎✅IgG4 at least once w PSC dx
📌Assoc. w AI pancreatitis; other Ig4 dis.
💎⬆️severity of UC, colectomy
📌More rapid progression to cirhhosis
💎Steroid responsive: ️ ⬇️AlPhos, TBili, IgG4
📌15% of LD-PSC
📌⬆️IgG4 serum>140mg/dL +/- tissue
💎✅IgG4 at least once w PSC dx
📌Assoc. w AI pancreatitis; other Ig4 dis.
💎⬆️severity of UC, colectomy
📌More rapid progression to cirhhosis
💎Steroid responsive: ️ ⬇️AlPhos, TBili, IgG4
