title: Primary biliary cirrhosis: clarifying the issues.
abstract: Primary biliary cirrhosis is a disease of unknown etiology characterized by the destruction of small intrahepatic bile ducts, probably on an immunologic basis. The disease predominantly affects females. Serum biochemical tests reveal cholestasis, and a serum mitochondrial antibody is usually present. Other diseases, largely autoimmune, may be associated. Main extra- and intrahepatic bile ducts are patent. Treatment is symptomatic, and particular attention must be paid to the control of pruritus and to the prevention of fat-soluble vitamin and calcium deficiencies. Many immunosuppressant drugs have been tested but largely abandoned because of their failure to prolong life, inability to improve hepatic histology, or side-effects. Hepatic transplantation is the ultimate solution and should be considered sooner rather than later. The disease probably recurs in the transplanted liver.
authors.affiliation: Department of Surgery, Royal Free Hospital School of Medicine, University of London, United Kingdom.
authors.forename: S
authors.initials: S
authors.lastname: Sherlock
mesh_terms: D003937:Diagnosis, Differential; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000209:etiology / Q000628:therapy