Primary Sclerosing Cholangitis

To the Editor: We recently reviewed the literature on primary sclerosing cholangitis while studying four cases diagnosed here since 1973. LaRusso et al. state that the course of the disease is generally one of slow progression to cirrhosis, portal hypertension, and death from liver failure, though the time course is unpredictable (April 5 issue).¹ The incidence of sclerosing cholangitis has increased by up to 100 per cent in many institutions since the introduction of endoscopic retrograde cholangiopancreatography.^2,3 Also, in two populations of patients with ulcerative colitis who were screened for hepatobiliary disease, the incidence of sclerosing cholangitis was put at.