Young man with ulcerative colitis who presents with fatigue, dark urine, mild jaundice, with a cholestatic pattern on LFTs (alk phos > ALT/AST), most consistent with primary sclerosing cholangitis
Primary sclerosing cholangitis: Classically seen in middle-aged men with ulcerative colitis, leads to beading of intra and extra-hepatic bile ducts on ERCP/MRCP, who has positive p-ANCA and elevated IgM
Primary biliary cholangitis: Classically seen in a middle-aged woman with other autoimmune diseases who has granulomas with lymphocytic infiltrate on biopsy, positive anti-mitochondrial antibody and elevated IgM
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