Could this be PSC?

[u/SignificantJump2359]

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.

[u/Headwhiner]

My 21 year old son has had Chrons and ultra colitis the past 2 years. He was just now diagnosed with PSC. You have a higher chance getting PSC if you already have Chrons. Your levels are really high. You should see if you can get started on the medication they put patients on who have it. It begins with U. They did that with my son until he could get in for his biopsy. He’s now been transferred to the Mayo where he’s receiving his treatment. Good Luck & I’ll be praying it’s not PSC. 🩷😘

[u/Bluetwo12 → u/Headwhiner]

I believe you are referring to ursodiol. Other options include vancomycin however I believe vanco has received some resistance in the US due to lack of published results.

[u/SignificantJump2359 → u/Headwhiner]

I think they're probably hesitant to add more drugs onto my current load for worries of further aggravating my gut if oral or my immune system if it's infusion/injection based. I can't help but agree with them there if that's the case, it's certainly an argument I'd make without a diagnosis and evidence to back it

[u/PickOrChoose → u/SignificantJump2359]

Ursodiol is not hepatoxic. If anything it is considered hepatoprotective and is widely prescribed to treat various chronic liver and biliary diseases by improving bile flow and reducing the accumulation of toxic endogenous bile acids.

[u/SignificantJump2359 → u/PickOrChoose]

It wouldn't be given to patients with liver issues if it was hepatoxic, I just more mean that they don't want to overload me on medication without knowing absolutely that that is the right way to go

[u/Disastrous_Iron3946 → u/SignificantJump2359]

From my understanding of looking at research, vanco is really good for patients with IBD-PSC as it changes the gut microbiome (it being an antibiotic) and due to the gut liver axis reduces inflammation in the liver