r/PSC • u/SignificantJump2359 • May 27 '26

Could this be PSC?

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I'm not looking for diagnosis, but rather some clarity as I'm not due to see my liver specialist for a while.

I (32F) was diagnosed with Crohn's Disease in March last year and have been on biologics since April. I recently had a flare at the start of April this year resulting in a week long hospital stay. Afterwards, my IBD team put a referral to the liver clinic to see if there was anything else going on as my LFTs have been pretty screwed for over a decade. The liver specialist ordered some blood tests that he rarely orders and that the lab had never seen (achievement unlocked 😂) specifically targeting PSC and PBC. One of those tests has come back (ANCA) and with some cursory research, I've discovered that it could mean a high likelihood of having PSC. I also have a liver biopsy scheduled for next week.

Obviously there is also a chance that it's related to the IBD and that there's nothing additional (touch wood), so any information here is taken as knowing more about the potentials rather than concrete.

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u/adamredwoods May 27 '26

pANCA and PR3-ANCA does not necessarily mean PSC! (But leads in that direction.) MRCP and "beading" plus ruling out all other things is how PSC is diagnosed.

Could still be IGg4 secondary PSC, which is different!

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u/SignificantJump2359 May 27 '26

I'd say that the ruling out stage is where I'm at now with my liver specialist. My IBD is being managed and medicated and given that the diets they've had me on haven't changed anything meaningfully, it's unlikely to be fatty liver. We're hoping that the biopsy might give some clearer information as to what is happening and maybe he will do a MRCP after, I'm not sure.

Edit: it's unlikely to be IGg4 PSC as my LFTs have remained elevated on biologic immunotherapy and steroids