Elevated serum levels of alkaline phosphatase

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A 38-year-old man present with jaundice and pruritus. Laboratory examination reveals markedly elevated serum levels of alkaline phosphatase. Antinuclear antibodies are not present, but a serologic test for p-ANCA is positive. And endoscopy cretrogradecholagiopancreatohraphy reveals "breeding" of the bile ducts. A liver biopsy specimen showed that many of the bile ducts to be surrounded by marked collagenous connective tissue deposition with epithelia trophy and luminal narrowing. What is the best diagnosis?

Reference no: EM133438107

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