review | primary biliary cirrhosis

File:Primary biliary cirrhosis intermed mag 2.jpg

I’d say there’s a proportion of you out there who’ve heard this term thrown around, hovering around in the back of your mind in regards to causes of cirrhosis, but if it came to actually explaining the pathophysiology and management, things may be a bit more difficult. Good time for a Lancet review then…

In fact, even after flipping through Harrison’s you may not have a complete idea to the processes that lead to this. A couple of important points:

  • it’s an important cause of chronic liver disease
  • often occurs in middle (around 50) aged women
  • it’s characterised by intrahepatic bile duct destruction, leading to cholestasis
  • there’s an autoimmune and genetic component
  • diagnosis is often made with a combination of liver function tests, a positive AMA, and liver biopsy
  • ursodeoxycholic acid slows the progression of disease (the earlier the better)
  • it’s becoming more common – which suggests some form of environmental provoking agent
  • the cure is liver transplantation
Now that you’ve got the brief rundown, why not take some time to check out the seminar over at the Lancet? It’s here

By the way, one of the key features of the above picture is the lymphocytic infiltration around the bile ducts – have a closer look. 

IMAGE Nephron

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