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[Primary biliary cirrhosis].

Branka Filipović1, Miroslav Oprić, Anka Milicić

  • 1Department of Alergology and Clinical Imunology, Bezhanijska Kosa Clinical and Hospital Centre, Belgrade. branka_filipovic@yahoo.com

Srpski Arhiv Za Celokupno Lekarstvo
|October 25, 2002
PubMed
Summary

Primary biliary cirrhosis, a chronic liver disease, can present with cholestasis and autoimmune markers. This case highlights its co-occurrence with hypertrophic cardiomyopathy in an elderly woman.

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Area of Science:

  • Hepatology
  • Internal Medicine
  • Autoimmunology

Background:

  • Primary biliary cirrhosis (PBC) is a chronic, autoimmune liver disease characterized by progressive destruction of intrahepatic bile ducts.
  • It predominantly affects middle-aged women and can lead to biliary cirrhosis.

Observation:

  • An elderly woman (78 years old) with hypertrophic cardiomyopathy presented with cholestasis, indicated by elevated alkaline phosphatase and gamma-glutamyl transferase.
  • Laboratory findings included hypercholesterolemia and low platelet count, suggesting an autoimmune etiology.
  • Diagnosis of PBC was confirmed by a high titer of antimitochondrial antibodies (1:640).

Findings:

  • The patient also had a urinary tract infection caused by Escherichia coli, suggesting a potential link between PBC and Gram-negative bacteria.
  • Liver biopsy served as an auxiliary diagnostic method.
  • Ursodeoxycholic acid was the primary therapeutic agent used.

Implications:

  • This case underscores the importance of considering PBC in elderly patients, even with co-existing cardiac conditions like hypertrophic cardiomyopathy.
  • The presentation highlights the diagnostic challenges when liver disease symptoms are masked by other comorbidities.
  • The co-occurrence of PBC with urinary tract infections warrants further investigation into potential microbial associations.

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