title: Primary biliary cirrhosis--a revised clinical spectrum.
abstract: The presentation or method of detection of 93 patients with primary biliary cirrhosis (PBC) from Northern England is reported. Almost half (45/93) the patients had no symptoms of liver disease when PBC was diagnosed; in many of them serum antimitochondrial activity (AMA) was detected during immunological screening for other diseases. 13 patients with normal liver function tests had symptomless PBC. Liver histology in 6 of these was diagnostic for PBC, and 7 had histology suggestive of PBC; all had a positive AMA titre greater than or equal to 1/40. The mortality of the symptom-free AMA-positive patients over a mean follow-up of 4-5 years did not differ from that of the general population. Only 1 out of 45 initially symptom-free patients died in the follow-up period (8 months-12 years). 37 patients had disorders which may be associated with PBC--including 16 with thyroid disease, 9 with rheumatoid arthritis, and 5 with mixed connective tissue disease. It is suggest that, as with autoimmune thyroid disease, overt organ damage never develops in many patients with symptomless PBC.
mesh_terms: D000328:Adult; D000368:Aged; D001323:Autoantibodies / Q000032:analysis; D001706:Biopsy; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000032:analysis; D008099:Liver / Q000473:pathology; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis* / Q000276:immunology / Q000401:mortality; D008297:Male; D008875:Middle Aged; D008930:Mitochondria, Liver / Q000276:immunology
chemical_list: D001323:Autoantibodies; D007075:Immunoglobulin M