title: Primary Biliary Cirrhosis with a normal Alkaline Phosphatase: a case report.
abstract: A 78 year-old lady presented with abdominal swelling and fatigue. She was anaemic with mild hypoalbuminaemia, and had a normal alkaline phosphatase. Computed tomography showed hepatosplenomegaly and mild ascites. Anti mitochondrial antibodies were strongly positive, as were anti nuclear antibodies, and the gamma glutamyl-transferase was shown to be elevated. A diagnosis of primary biliary cirrhosis was made. A brief discussion of treatment of primary biliary cirrhosis follows. The case is notable for the fact that primary biliary cirrhosis can manifest clinically without an elevation in alkaline phosphatase - normally the hallmark of the disease.
authors.affiliation: 34 Fitzjohns Avenue, London , NW3 5NB, UK. joshbrostoff@doctors.org.uk.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Brostoff
authors.forename: Sukaina
authors.initials: S
authors.lastname: Rashid
authors.forename: Daniel
authors.initials: D
authors.lastname: McCrea