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Asymptomatic primary biliary cirrhosis.

R A Fox, P J Scheuer, S Sherlock

    Gut
    |June 1, 1973
    PubMed
    Summary
    This summary is machine-generated.

    This study identifies four asymptomatic patients with elevated alkaline phosphatase and positive mitochondrial antibodies, suggesting early primary biliary cirrhosis. Liver biopsies revealed bile duct damage, indicating a need for further investigation in similar cases.

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    Area of Science:

    • Hepatology
    • Immunology
    • Gastroenterology

    Background:

    • Primary biliary cirrhosis (PBC) is a chronic liver disease.
    • Early diagnosis of PBC is crucial for management.
    • Asymptomatic presentations of PBC can be challenging to identify.

    Purpose of the Study:

    • To describe a cohort of asymptomatic patients with potential early primary biliary cirrhosis.
    • To highlight key diagnostic markers in these patients.
    • To investigate the immunological and histological findings in asymptomatic PBC.

    Main Methods:

    • Case series of four asymptomatic patients.
    • Biochemical tests including serum alkaline phosphatase.
    • Immunological tests: serum mitochondrial antibody, lymphocyte transformation tests.
    • Histopathological examination of liver biopsies.
    • Skin and serological tests for dinitrochlorobenzene and haemocyanin.

    Main Results:

    • All four patients had raised serum alkaline phosphatase and positive mitochondrial antibody tests.
    • Liver biopsies showed destructive bile duct lesions in all cases.
    • Lymphocyte transformation was normal in three patients; one with rheumatoid arthritis showed impairment.
    • Immune responses to dinitrochlorobenzene and haemocyanin were normal in two patients.

    Conclusions:

    • The findings suggest these patients represent an asymptomatic stage of primary biliary cirrhosis.
    • Elevated alkaline phosphatase and mitochondrial antibodies are key indicators.
    • Destructive bile duct lesions on biopsy confirm the diagnosis even in asymptomatic individuals.