Bsc
| Biliary Cirrhosis | |
|---|---|
| Synonyms | N/A |
| Pronounce | N/A |
| Specialty | N/A |
| Symptoms | Fatigue, pruritus, jaundice |
| Complications | Liver failure, portal hypertension, osteoporosis |
| Onset | |
| Duration | |
| Types | N/A |
| Causes | Autoimmune destruction of bile ducts |
| Risks | Female gender, genetic predisposition |
| Diagnosis | Liver biopsy, antimitochondrial antibody test |
| Differential diagnosis | N/A |
| Prevention | N/A |
| Treatment | Ursodeoxycholic acid, liver transplant |
| Medication | N/A |
| Prognosis | Variable, depends on stage at diagnosis |
| Frequency | |
| Deaths | N/A |
Overview
Biliary Cirrhosis is a chronic liver disease characterized by progressive destruction of the small and medium-sized bile ducts within the liver. This leads to cholestasis, fibrosis, and eventually cirrhosis. The condition is primarily autoimmune in nature and is more prevalent in women.
Pathophysiology
The pathogenesis of biliary cirrhosis involves an autoimmune attack on the bile ducts. The immune system mistakenly targets the epithelial cells lining the bile ducts, leading to inflammation and destruction. Over time, this results in cholestasis, where bile cannot flow from the liver to the duodenum, causing liver damage and fibrosis.
Clinical Presentation
Patients with biliary cirrhosis often present with non-specific symptoms such as fatigue and pruritus. As the disease progresses, jaundice, hepatomegaly, and signs of portal hypertension may develop. Advanced disease can lead to complications such as liver failure and osteoporosis.
Diagnosis
Diagnosis of biliary cirrhosis is based on clinical, biochemical, and histological findings. Key diagnostic tests include:
- Liver function tests showing cholestatic pattern
- Presence of antimitochondrial antibodies (AMA) in the blood
- Liver biopsy demonstrating bile duct destruction and fibrosis
Management
The primary treatment for biliary cirrhosis is ursodeoxycholic acid, which can slow disease progression. In cases of advanced cirrhosis, liver transplantation may be necessary. Management also includes addressing symptoms such as pruritus and monitoring for complications like osteoporosis.
Prognosis
The prognosis of biliary cirrhosis varies depending on the stage at diagnosis and response to treatment. Early diagnosis and treatment can improve outcomes, but advanced disease may lead to liver failure and require transplantation.
Epidemiology
Biliary cirrhosis is more common in women, with a female-to-male ratio of approximately 9:1. It typically presents in middle-aged individuals, although it can occur at any age.
See Also
External Links
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Contributors: Prab R. Tumpati, MD