A 35-year-old man with known ulcerative colitis presents with pruritus and elevated alkaline phosphatase (480 U/L) with GGT 520 U/L. MRCP shows multifocal strictures and dilatations of intrahepatic and extrahepatic bile ducts giving a 'beaded' appearance. Which autoantibody is most commonly associated with this condition?

• A Anti-mitochondrial antibody (AMA)
• B Anti-smooth muscle antibody (ASMA)
• C Anti-LKM-1 antibody
• D Perinuclear anti-neutrophil cytoplasmic antibody (p-ANCA) ✓

Explanation

Primary sclerosing cholangitis (PSC) classically shows the 'beaded' appearance on cholangiography due to alternating strictures and dilatations. It is strongly associated with ulcerative colitis. p-ANCA is positive in 60-80% of PSC patients. AMA is characteristic of primary biliary cholangitis, while ASMA and anti-LKM-1 are seen in autoimmune hepatitis.

Reference: Harrison's Principles of Internal Medicine, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.