The 2024 diagnostic criteria for primary sclerosing cholangitis.

IF 6.9 2区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Journal of Gastroenterology Pub Date : 2025-06-12 DOI:10.1007/s00535-025-02265-5

Itaru Naitoh, Hiroyuki Isayama, Nobuhisa Akamatsu, Suguru Mizuno, Toshio Fujisawa, Nobuhiro Nakamoto, Yousuke Nakai, Shuichiro Umetsu, Mitsuyoshi Suzuki, Shintaro Yagi, Hironori Haga, Kenji Notohara, Katsuhiro Sano, Susumu Tazuma, Takahiro Nakazawa, Atsushi Tanaka

{"title":"The 2024 diagnostic criteria for primary sclerosing cholangitis.","authors":"Itaru Naitoh, Hiroyuki Isayama, Nobuhisa Akamatsu, Suguru Mizuno, Toshio Fujisawa, Nobuhiro Nakamoto, Yousuke Nakai, Shuichiro Umetsu, Mitsuyoshi Suzuki, Shintaro Yagi, Hironori Haga, Kenji Notohara, Katsuhiro Sano, Susumu Tazuma, Takahiro Nakazawa, Atsushi Tanaka","doi":"10.1007/s00535-025-02265-5","DOIUrl":null,"url":null,"abstract":"<p><p>Primary sclerosing cholangitis (PSC) is an idiopathic chronic cholestatic disease with a poor prognosis. As there were no specific biomarkers for diagnosing PSC, we developed diagnostic criteria in 2016 based on cholangiography and elevated biliary enzymes. Novel findings and knowledge have subsequently accumulated, and we now propose the 2024 diagnostic criteria, to overcome several limitations of the 2016 diagnostic criteria. The Intractable Hepato-Biliary Diseases Study Group in Japan of the Committee of Research on Measures for Intractable Diseases established a working group consisting of experts in PSC comprising gastroenterologists, endoscopists, hepatologists, liver-transplant surgeons, pediatric hepatologists, pathologists, and radiologists. This working group proposed the 2024 diagnostic criteria after several discussions and public hearings. There are additional diagnostic targets; small duct PSC, pediatric PSC, and PSC recurrence following liver transplantation differ from the 2016 diagnostic criteria, which were for diagnosing large duct PSC in adults. The 2024 diagnostic criteria facilitate the use of magnetic resonance cholangiography in addition to endoscopic retrograde cholangiography in imaging, and incorporate gamma-glutamyl transferase for evaluating cholestasis to diagnose pediatric patients. Furthermore, PSC recurrence following liver transplantation can be diagnosed based on a liver biopsy and characteristic biliary findings. We hope that the 2024 diagnostic criteria will help not only hepatologists treating adults but also general physicians, pediatric hepatologists, and liver-transplant surgeons who manage patients with various forms of PSC.</p>","PeriodicalId":16059,"journal":{"name":"Journal of Gastroenterology","volume":" ","pages":""},"PeriodicalIF":6.9000,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Gastroenterology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00535-025-02265-5","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Primary sclerosing cholangitis (PSC) is an idiopathic chronic cholestatic disease with a poor prognosis. As there were no specific biomarkers for diagnosing PSC, we developed diagnostic criteria in 2016 based on cholangiography and elevated biliary enzymes. Novel findings and knowledge have subsequently accumulated, and we now propose the 2024 diagnostic criteria, to overcome several limitations of the 2016 diagnostic criteria. The Intractable Hepato-Biliary Diseases Study Group in Japan of the Committee of Research on Measures for Intractable Diseases established a working group consisting of experts in PSC comprising gastroenterologists, endoscopists, hepatologists, liver-transplant surgeons, pediatric hepatologists, pathologists, and radiologists. This working group proposed the 2024 diagnostic criteria after several discussions and public hearings. There are additional diagnostic targets; small duct PSC, pediatric PSC, and PSC recurrence following liver transplantation differ from the 2016 diagnostic criteria, which were for diagnosing large duct PSC in adults. The 2024 diagnostic criteria facilitate the use of magnetic resonance cholangiography in addition to endoscopic retrograde cholangiography in imaging, and incorporate gamma-glutamyl transferase for evaluating cholestasis to diagnose pediatric patients. Furthermore, PSC recurrence following liver transplantation can be diagnosed based on a liver biopsy and characteristic biliary findings. We hope that the 2024 diagnostic criteria will help not only hepatologists treating adults but also general physicians, pediatric hepatologists, and liver-transplant surgeons who manage patients with various forms of PSC.

查看原文本刊更多论文

原发性硬化性胆管炎2024诊断标准。

原发性硬化性胆管炎（PSC）是一种特发性慢性胆汁淤积症，预后较差。由于没有诊断PSC的特异性生物标志物，我们在2016年制定了基于胆管造影和胆道酶升高的诊断标准。新的发现和知识随后积累，我们现在提出2024诊断标准，以克服2016诊断标准的几个局限性。日本顽固性肝胆疾病研究委员会的顽固性肝病研究组成立了一个由PSC专家组成的工作组，包括胃肠病学家、内窥镜专家、肝病学家、肝移植外科医生、儿科肝病学家、病理学家和放射科医生。该工作组在经过多次讨论和公开听证会后提出了2024年诊断标准。还有其他诊断目标；小管PSC、儿童PSC和肝移植后PSC复发的诊断标准与2016年诊断成人大管PSC的诊断标准不同。2024诊断标准促进了在内镜逆行胆管造影的基础上使用磁共振胆管造影，并结合γ -谷氨酰转移酶评估胆汁淤积来诊断儿科患者。此外，肝移植后PSC复发可以根据肝活检和特征性胆道检查来诊断。我们希望2024年的诊断标准不仅能帮助治疗成人的肝病学家，还能帮助治疗各种形式PSC患者的普通内科医生、儿科肝病学家和肝移植外科医生。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of Gastroenterology 医学-胃肠肝病学

CiteScore

12.20

自引率

1.60%

发文量

审稿时长

4-8 weeks

期刊介绍： The Journal of Gastroenterology, which is the official publication of the Japanese Society of Gastroenterology, publishes Original Articles (Alimentary Tract/Liver, Pancreas, and Biliary Tract), Review Articles, Letters to the Editors and other articles on all aspects of the field of gastroenterology. Significant contributions relating to basic research, theory, and practice are welcomed. These publications are designed to disseminate knowledge in this field to a worldwide audience, and accordingly, its editorial board has an international membership.