Vedolizumab: a novel medical intervention in the treatment of primary sclerosing cholangitis

Description

Primary sclerosing cholangitis (PSC) is an idiopathic and insidious cholestatic liver disease characterised by persistent inflammation of the biliary tree, leading to fibrosis and stricturing.1 Often associated with inflammatory bowel disease, pathogenesis may be related to activated intestinal T-cells expressing the integrin cell surface receptor α₄β₇. These T-cells are recruited to the liver parenchyma resulting in persistent biliary inflammation.1 Patients typically remain asymptomatic until a diagnosis is attained by detection of elevated liver enzymes.2 No effective medical management exists, and the progressive fibrotic nature of the disease usually results in the necessity of liver transplantation.

We present a case of a male in his 40s with a 30-year history of ulcerative colitis and newly diagnosed PSC, who demonstrated an improvement in inflammation and stricturing of the biliary tree with vedolizumab (figure 1). On routine follow-up our patient was found to...

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