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Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune disease of the liver. [ 1 ] [ 2 ] [ 3 ] It results from a slow, progressive destruction of the small bile ducts of the liver, causing bile and other toxins to build up in the liver, a condition called cholestasis .
Primary biliary cirrhosis is a serious autoimmune disease of the bile capillaries. [17] Primary sclerosing cholangitis is a serious chronic inflammatory disease of the bile duct, which is believed to be autoimmune in origin. [18] Budd–Chiari syndrome is the clinical picture caused by occlusion of the hepatic vein. [19]
In primary biliary cholangitis (previously known as primary biliary cirrhosis), the bile ducts become damaged by an autoimmune process. [44] This leads to liver damage. [52] Some people may have no symptoms, while others may present with fatigue, pruritus, or skin hyperpigmentation. [55]
On rare occasions, it can produce features similar to primary biliary cirrhosis due to progressive destruction of small bile ducts (vanishing duct syndrome). Causes: (a) Bland: Oral contraceptive pills, anabolic steroid, androgens (b) Inflammatory: Allopurinol, co-amoxiclav, carbamazepine (c) Ductal: Chlorpromazine, flucloxacillin
Cholestatic pruritus is the sensation of itch due to nearly any liver disease, but the most commonly associated entities are primary biliary cholangitis, primary sclerosing cholangitis, obstructive choledocholithiasis, carcinoma of the bile duct, cholestasis (also see drug-induced pruritus), and chronic hepatitis C viral infection and other forms of viral hepatitis.
Liver cirrhosis can develop in about 7% to 40% of treated patients. People with the highest risk for progression to cirrhosis are those with incomplete response to treatment, treatment failure, and multiple relapses. Once cirrhosis develops, management of liver cirrhosis in autoimmune hepatitis is standard regardless of etiology.
biliary dyskinesia; ICD-10 code K83: other diseases of the biliary tract: cholangitis (including ascending cholangitis and primary sclerosing cholangitis) obstruction, perforation, fistula of biliary tract (bile duct) spasm of sphincter of Oddi; biliary cyst; biliary atresia
The bile duct scarring that occurs in PSC narrows the ducts of the biliary tree and impedes the flow of bile to the intestines. Eventually, it can lead to cirrhosis of the liver and liver failure. PSC increases the risk of various cancers, including liver cancer, gallbladder carcinoma, colorectal cancer, and cholangiocarcinoma.
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