Diagnosis and therapy of sclerosing cholangitis -The consistency of the new diagnostic criteria-

Abstract

The diagnosis of sclerosing cholangitis is difficult even with the recent advanced imaging techniques. Especially, it is not easy to discriminate IgG4-related sclerosing cholangitis (IgG4-SC) from those progressive or malignant diseases, such as primary sclerosing cholangitis (PSC), cholangiocarcinoma. Therefore, the Research Committee provided by the Ministry of Health, Labor, and Welfare of Japan and the Japan Biliary Association proposed the new clinical diagnostic criteria of IgG4-SC 2012. We should make a precise diagnosis of sclerosing cholangitis from various aspects of clinical course, serology, ductal imaging, other organ involvement and histological findings. There are several problems remained to be resolved in the therapy of IgG4-SC and PSC. Improvement of diagnostic precision and therapeutic effect of IgG4-SC and PSC are expected with further fundamental and clinical investigations.