Primary sclerosing cholangitis - What is the difference between east and west?

Table 1 Mayo criteria for the diagnosis of PSC[27]

	Mayo criteria
Typical cholangiographic abnormalities involving any part of the biliary tree	Multifocal stricturing and beading, usually involving both the intrahepatic and extrahepatic biliary system
Compatible clinical and biochemical findings (for longer than 6 mo)	Cholestatic symptoms, history of inflammatory bowel disease
	Twofold to threefold increase in serum alkaline phosphatase levels
Exclusion of identifiable causes of secondary sclerosing cholangitis	AIDS cholangiopathy
	Bile duct neoplasm (unless diagnosis of PSC previously established)
	Biliary tract surgery, trauma
	Choledocholithiasis
	Congenital abnormalities of biliary tract
	Caustic sclerosing cholangitis
	Ischemic stricturing of bile ducts
	Toxicity or stricturing of bile ducts related to intra-arterial infusion of floxuridine

Table 2 Comparison of characteristics of PSC patients: European and Japanese studies

Parameter	Takikawa (n = 388)	Broome (n = 305)	Ponsioen (n = 174)	Tischendorf (n = 273)
Age (yr)	47	39	40.4	32.4
Male (%)	59	64	60	71
Symptoms
Jaundice	28	30	NA	NA
Pruritus	16	30	NA	NA
IBD	37	81	66	63
CD	2.4	7	13.2	10.6
UC	29	72	47.7	51.7
Laboratory
ALP	88	91.5	NA	NA
Bilirubin	39	41	NA	40
pANCA (+)	13	NA	NA	69
Diagnostic procedures
ERC	80	87.2	76.4	100
MRC	32	NA	NA	NA
Liver biopsy	78	83.2	NA	100
BD involvement
SD	1.6	0	NA	3.3
Only EHBD	4.8	6	NA	3.7
Only IHBD	27	27	NA	24.9
IHBD+EHBD	68	67	NA	68.1
Treatment
UDCA	78	NA	NA	NA
Steroid	31	NA	NA	NA
Endoscopy	14	NA	NA	NA
Liver transplantation	10	NA	8	39.6