Primary biliary cholangitis

Question 1

How may a patient with primary biliary cholangitis present?

Answer 1

Fatigue
Pruritus
GI disturbance
RUQ
Jaundice
Pale stools
Xanthoma and xantholesma
Signs of cirrhosis and failure

Question 2

What group of patients are associated with primary biliary cholangitis?

Answer 2

Middle aged women

Thyroid disease

Rheumatoid conditions:
Sjogren’s syndrome (80% of patients)
Systemic sclerosis
Rheumatoid arthritis

Question 3

How is primary biliary cholangitis diagnosed?

Answer 3

Anti-mitochondrial antibodies (AMA) M2 subtype
Smooth muscle antibodies
Raised serum IgM
Raised ESR

Question 4

What treatment is given in primary biliary cholangitis?

Answer 4

1st line = Ursodeoxycholic acid

Pruritus - give cholestyramine

Question 5

What complications can arise in primary biliary cholangitis?

Answer 5

Cirrhosis - leads to portal hypotension - leads to ascites and oesophageal varies (lead to variceal bleeding)
Osteomalacia and osteoporosis
x20 increased risk of hepatocellular carcinoma