What is the Difference Between Primary Biliary Cirrhosis and Primary Sclerosing Cholangitis?
🆚 Go to Comparative Table 🆚Primary Biliary Cirrhosis (PBC) and Primary Sclerosing Cholangitis (PSC) are both chronic cholestatic liver diseases that cause inflammation and damage to the bile ducts, leading to liver cirrhosis. However, there are some differences between the two conditions:
- Site of disease involvement: PBC affects only the intrahepatic bile ducts within the liver, while PSC affects all of the bile ducts, including the extrahepatic ducts.
- Mode of diagnosis: PSC is usually diagnosed by MRI of the bile ducts, while PBC is diagnosed using a combination of two of the following: raised alkaline phosphatase (ALP), antimitochondrial antibodies (AMA), or a liver biopsy.
- Population affected: PBC and PSC tend to affect different populations. PBC primarily affects women, while PSC affects both men and women.
- Treatment: Although PBC and PSC share certain symptoms and characteristics, they require different treatments. PBC can be treated with medication to slow the progress of the disease, while there is currently no effective treatment for PSC.
- Progression: Both PBC and PSC are slowly progressive disorders, taking 10–20 years to advance from early to end-stage liver disease.
Despite these differences, both PBC and PSC are considered autoimmune cholangiopathies and share features of portal biliary tract injury, fibrosis, and cirrhosis development, leading to end-stage liver failure.
Comparative Table: Primary Biliary Cirrhosis vs Primary Sclerosing Cholangitis
Primary Biliary Cholangitis (PBC) and Primary Sclerosing Cholangitis (PSC) are two major types of chronic cholestatic liver diseases that share certain similarities but have distinct differences. Here is a table comparing the two:
| Feature | Primary Biliary Cholangitis (PBC) | Primary Sclerosing Cholangitis (PSC) |
|---|---|---|
| Site of disease involvement | Small bile ducts inside the liver only | Bile ducts inside and outside the liver, with 10-15% of patients only affecting small ducts inside the liver |
| Mode of diagnosis | Diagnosed by two of the following: raised alkaline phosphatase (ALP), anti-mitochondrial antibodies (AMA), or liver biopsy | Usually diagnosed by MRI of bile ducts, occasionally liver biopsy or ERCP is needed |
Both PBC and PSC are considered immune-mediated cholangiopathies and have features of portal biliary tract injury, sequential fibrosis, and cirrhosis development, leading to end-stage liver failure. However, PBC primarily involves damage to small ducts inside the liver, whereas PSC involves damage to both small and large bile ducts inside and outside the liver.
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