[Clinical features and prognosis of primary biliary cirrhosis in Korea].
OBJECTIVE
This study investigated the clinical features and prognosis of primary biliary cirrhosis (PBC) in Korea.


METHODS
Clinical data of patients diagnosed as PBC between 1997 and 2008 at eight referral hospitals were analyzed retrospectively. PBC was diagnosed based on liver function tests, presence of serum antimitochondrial antibody (AMA), and histopathological findings.


RESULTS
In total, 251 patients (218 females, 33 males; mean age 54 years) were enrolled, and the mean follow-up duration was 33.5 months. At the diagnosis, 61% of the patients were asymptomatic, 12% had decompensated liver cirrhosis, and 98% were positive for AMA. The serum alkaline phosphate (ALP) level was 2.6 times the upper limit of normal, aspartate aminotransferase was 105 U/L, and bilirubin was 2.0 mg/dL. The mean Mayo risk score was 5.5, and the Child-Pugh class was A, B, and C in 79%, 19%, and 2% of the patients, respectively. Ursodeoxycholic acid (UDCA) was used for treatment in 88% of the patients, among which 70% exhibited biochemical responses defined as normalization or a > 40% decrease in ALP at 6 months. Eight deaths occurred during the follow-up; the causes were variceal bleeding, hepatic failure, and sepsis. The overall 5-year survival rate was 95%. The poor prognostic factors were being older than 60 years, high bilirubin, low albumin, ascites, high Mayo risk score, Child-Pugh class C, and initial presence of hepatic decompensation.


CONCLUSIONS
Most patients diagnosed as PBC were asymptomatic, and these patients had a favorable short-term prognosis. The prognosis of PBC was dependent on the initial severity of liver disease.
Kim
Kyung-Ah
KA
Department of Internal Medicine, Ilsan Paik Hospital, Inje University, Korea.
Jeong
Sook-Hyang
SH
Lee
Jung Il
JI
Yeon
Jong Eun
JE
Lee
Heon Ju
HJ
Kwon
So Young
SY
Chang
U Im
UI
Min
Hyun Ju
HJ
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000378:metabolism; D001426:Bacterial Proteins / Q000097:blood; D010450:Endopeptidases / Q000097:blood; D005260:Female; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis* / Q000188:drug therapy / Q000401:mortality; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D056910:Republic of Korea; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015996:Survival Rate; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
D001323:Autoantibodies; D001426:Bacterial Proteins; D014580:Ursodeoxycholic Acid; D010450:Endopeptidases; C087822:alkaline protease