• Patients with primary sclerosing cholangitis (PSC) may be symptom-free on presentation, although jaundice, pruritis, upper right quadrant abdominal pain, a history of fatigue, and recent weight loss are common
  • Approximately 80% of patients with PSC have inflammatory bowel disease
  • Imaging of the biliary tree (cholangiography) is central in the diagnosis of PSC. Endoscopic retrograde cholangiopancreatography has traditionally been considered the gold standard in PSC diagnosis; however, magnetic resonance cholangiopancreatography is of comparable diagnostic accuracy and is noninvasive
  • Patients are at increased risk for hepatobiliary tumors, in particular cholangiocarcinoma; PSC also confers an increased risk for pancreatic cancer and colon cancer
  • Biliary tract abscess and sepsis, if suspected, require early treatment with intravenous fluids and broad-spectrum antibiotics and referral to a specialized center
  • Liver transplantation is the only therapy with a significant impact on survival

 

 

 

 

 

 

Most people with pyelonephritis do not have complications if appropriately treated with bacteria-fighting medications called antibiotics.

In rare cases, pyelonephritis may cause permanent kidney scars, which can lead to chronic kidney disease, high blood pressure, and kidney failure. These problems usually occur in people with a structural problem in the urinary tract, kidney disease from other causes, or repeated episodes of pyelonephritis.

Infection in the kidneys may spread to the bloodstream—a serious condition called sepsis—though this is also uncommon.

 

 

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