I just came across your post this morning. I was diagnosed with small duct PSC through a liver biopsy. I don't know about "early" versus "small duct" but I can tell you that I have been living with small duct PSC for about 40 years. (Now 85) There is a potential for small duct to progress to issues with the main duct, but so far that has not happened. I also had ulcerative colitis and was receiving Remicade treatments once a month to keep my autoimmune system in control and getting a blood work and a colonoscopy every 6 months. 12 years ago, I had to have my colon removed, and shortly after that my liver enzymes levels returned to the normal range. My GI doctor did not have an explanation for the enzyme levels returning to the normal range. Also, I have never had any other PSC symptoms like jaundice and itching. Not sure if this helps but tell your son that having PSC is not the end of the world.