<prompt> A patient presenting with history of diarrhoea for several years with recent onset pruritus and raised alkaline phosphatase, normal SGOTPT and USG shows no gallstones and biliary tract abnormality, the diagnosis isHodgkins lymphomaSclerosing cholangitisAutoimmune hepatitisViral hepatitis  <response>: Symptoms of PSC Evidence of cholestatic liver disease - Jaundice, Pruritus and fatigue Diagnosis Asymptomatic elevation of GGT is the earliest finding, ALP and bile acids are also increased. Cholangiography - diagnoisis of PSC with evidence of diffuse multifocal strictures found in both intrahepatic and extrahepatic bile ducts Ref: Sabiston 20th edition Pgno :1508-1509 