Risk Factors and Prediction of Long-term Outcome in Primary Biliary Cirrhosis

Hiromi Ishibashi, Atsumasa Komori, Shinji Shimoda, Yoko M. Ambrosini, M. Eric Gershwin, Minoru Nakamura

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

The natural history of the disease varies greatly among individual patients with primary biliary cirrhosis (PBC). Some patients live long without any symptoms while other patients present jaundice and develop hepatic failure in early phases of the disease. Previous studies showed that the natural course of PBC is altered by the use of ursodeoxy cholic acid (UDCA). In this review we discuss variation in the natural course of the disease and it's alteration by UDCA, and risk factors that predict disease progression. Based on clinical observations, there are three types of clinical evolution in PBC: 1) minimal to slow progression over several years; 2) rapid progression to jaundice and hepatic failure, and 3) progression to portal hypertension without developing deep jaundice. Notably, based on our analyses accelerated progression to jaundice and liver failure are reflected by a sustained serologic presence of anti-gp210 antibodies whereas patients with portal hypertension in the absence of jaundice have anti-centromere autoantibodies. These observations highlight the clinical importance of antinuclear antibody analysis in patients with PBC.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalInternal Medicine
Volume50
Issue number1
DOIs
StatePublished - 2011

Keywords

  • Autoantibody
  • Centromere
  • gp210
  • Natural history
  • Primary biliary cirrhosis
  • Prognosis

ASJC Scopus subject areas

  • Internal Medicine

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