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Adenopathies: A Confusing Presentation of Primary Biliary Cholangitis
Catarina Maciel1, Daniela Augusto1, Nadia Tenreiro2
1Internal Medicine, Centro Hospitalar Trás-Os-Montes e Alto Douro (CHTMAD), Vila Real, PRT.
Cureus
|February 23, 2023
Summary
Primary biliary cholangitis (PBC), an autoimmune liver disease, can present with unusual symptoms like adenopathies. Early diagnosis and treatment of PBC are crucial for symptom resolution and preventing disease progression.
Area of Science:
- Hepatology
- Autoimmune Diseases
- Gastroenterology
Background:
- Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by the destruction of intrahepatic bile ducts.
- Common symptoms include fatigue, pruritus, steatorrhea, and jaundice, but the clinical course is variable.
Observation:
- A 65-year-old woman presented with anorexia, weight loss, asthenia, and pruritus.
- Imaging revealed dilated intrahepatic and common bile ducts with hepatoduodenal ligament adenopathies, initially diagnosed as reactive lymphadenitis.
- Neoplasia was excluded, and further investigation revealed anti-mitochondrial autoantibodies, indicative of PBC.
Findings:
- Treatment initiation led to the resolution of the patient's clinical symptoms.
- Subsequent studies showed no detectable adenopathies, suggesting a link between PBC and the observed lymphadenopathy.
Implications:
- This case highlights the importance of considering PBC in the differential diagnosis of patients presenting with constitutional symptoms and adenopathies.
- Recognizing atypical presentations of PBC is crucial for timely diagnosis and effective management.
- The resolution of adenopathies following PBC treatment underscores the systemic nature of the disease and the impact of targeted therapy.
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