Table 1.

Natural history and clinical features in PSC.

Asymptomatic phase	no clinical symptoms cholangiographic abnormalities normal biochemistry
Biochemical phase	asymptomatic biochemical abnormalities
Symptomatic phase	fatigue pruritus and excoriations jaundice fever, chills, night sweats, and right upper quadrant pain * diarrhea and bloody stools **
Decompensated cirrhosis	jaundice ascites muscle atrophy spider telangiectasias peripheral edema hepatosplenomegaly xanthelasma hepatic encephalopathy variceal bleeding

* These symptoms appear in episodic bacterial cholangitis due to biliary obstruction [2]. ** Even if these symptoms are frequent in PSC associated with IBD, bleeding from portal hypertension should be investigated [4].