The Japanese Society of Gastroenterology listed criteria for the diagnosis of primary sclerosing cholangitis.
Major criteria:
(1) biliary tract imaging (characteristic findings: band-like stricture, pruned-tree appearance, beaded appearance, diverticulum-like outpoching, shaggy appearance)
(2) serum alkaline phosphatase
Minor criteria:
(1) inflammatory bowel disease
(2) histology showing fibrous cholangitis/onion skin lesion
Definite diagnosis
(1) cholangiographic findings characteristic for PSC
(2) one or more of the following:
(2a) increased serum alkaline phosphatase
(2b) inflammatory bowel disease
(2c) fibrous cholangitis (onion skin lesion) on liver histology
(3) exclusion of IgG4 sclerosing cholanigits, secondary sclerosing cholangitis, biliary cancer or other condition that can explain the findings better
Definite diagnosis
(1) cholangiographic findings not characteristic for PSC
(2) all of the following:
(2a) increased serum alkaline phosphatase
(2b) inflammatory bowel disease
(2c) fibrous cholangitis (onion skin lesion) on liver histology
(3) exclusion of IgG4 sclerosing cholanigits, secondary sclerosing cholangitis, biliary cancer or other condition that can explain the findings better
Probable diagnosis:
(1) cholangiographic findings characteristic for PSC
(2) exclusion of IgG4 sclerosing cholanigits, secondary sclerosing cholangitis, biliary cancer or other condition that can explain the findings better
Probable diagnosis
(1) cholangiographic findings not characteristic for PSC
(2) two of the following:
(2a) increased serum alkaline phosphatase
(2b) inflammatory bowel disease
(2c) fibrous cholangitis (onion skin lesion) on liver histology
(3) exclusion of IgG4 sclerosing cholanigits, secondary sclerosing cholangitis, biliary cancer or other condition that can explain the findings better
Possible diagnosis
(1) cholangiographic findings not characteristic for PSC
(2) one of the following:
(2a) increased serum alkaline phosphatase
(2b) inflammatory bowel disease
(2c) fibrous cholangitis (onion skin lesion) on liver histology
(3) exclusion of IgG4 sclerosing cholanigits, secondary sclerosing cholangitis, biliary cancer or other condition that can explain the findings better
