u/Excellent-Bet-4394

Some people with small-duct PSC have a rapid improvement in their liver blood tests after starting UDCA, and their ALP and GGT levels return to the normal range. In others, ALP and GGT remain elevated despite taking UDCA.

Is the long-term prognosis different between these two groups? Does normalization of ALP and GGT suggest a lower risk of disease progression, worsening fibrosis, or progression from small-duct PSC to large-duct PSC?

As far as I know, unlike in PBC, UDCA has not been clearly proven to slow the progression of PSC or improve long-term outcomes. So, does normalization of liver enzymes indicate a better prognosis, or does it only show that the blood test results have improved?

I would be interested to hear about other people’s experiences or any studies on this topic.

I was diagnosed last yearMy liver enzymes were initially quite elevated: ALP 220, GGT 480, ALT around 200, and AST around 150. After starting Imuran (azathioprine) and UDCA, they dropped into the normal range relatively quickly. I have suspected overlap syndrome, but my liver biopsy showed pure autoimmune hepatitis (AIH) without clear bile duct damage. My (AMA) is negative, (ANA) is positive. IgM is normal, and MRCP was normal as well. I’m currently taking Imuran (azathioprine) and UDCA. Whenever I stop UDCA, my ALP and GGT rise significantly, and ALT/AST also go up. When I restart UDCA, everything goes back into the normal range quite quickly. My current labs are: ALT 22, AST 20, ALP 62, GGT 45. lgG 1360 Has anyone experienced something similar — biopsy showing pure AIH, but a very clear biochemical response to UDCA? I’d be very interested to hear your thoughts.

Hi everyone 🌿

I think the choice of antibiotics and painkillers is really important for people with autoimmune hepatitis, especially during dental procedures like tooth extractions, implants, or root canals. Unfortunately, not everydoctor seems fully aware of the liver related risks.

What do you personally pay attention to during these treatments?

Are there any medications you consider safer, or any that you specifically avoid? 🙏