Predicting outcome in primary biliary cirrhosis

Journal Title: Annals of Hepatology - Year 2014, Vol 13, Issue 4

Abstract

Primary biliary cirrhosis (PBC) is a slowly progressive autoimmune liver disease that may ultimately result in liver failure and premature death. Predicting outcome is of key importance in clinical management and an essential requirement for patients counselling and timing of diagnostic and therapeutic interventions. The following factors are associated with progressive disease and worse outcome: young age at diagnosis, male gender, histological presence of cirrhosis, accelerated marked uctopenia in relation to the amount of fibrosis, high serum bilirubin, low serum albumin levels, high serum alkaline phosphatase levels, esophageal varices, hepatocellular carcinoma (HCC) and lack of biochemical response to ursodeoxycholic acid (UDCA). The prognostic significance of symptoms at diagnosis is uncertain. UDCA therapy and liver transplantation have a significant beneficial effect on the outcome of the disease. The Mayo risk score in PBC can be used for estimating individual prognosis. The Newcastle Varices in PBC Score may be a useful clinical tool to predict the risk for development of esophageal varices. Male gender, cirrhosis and non-response to UDCA therapy in particular, are risk factors for development of HCC.

Authors and Affiliations

Willem J. Lammers, Kris V. Kowdley, Henk R. van Buuren

Keywords

Related Articles

Association of baseline CD4+ cell count and HIV-RNA on sustained virologic response to interferon-ribavirin in HIV/HCV coinfected patients

Background and rationale for the study. We assessed the association of CD4+ T-cell counts and HIV-RNA on sustained viral response (SVR) after therapy with pegylated interferon and ribavirin (PR) in HIV/HCV coinfected pat...

Impact of MELD score implementation on liver allocation: experience at a Brazilian center

Introduction. Model for end-stage liver disease (MELD) is an accurate predictor of mortality in patients with cirrhosis, and has been used on liver allocation in Brazil since 2006. However, its impact on organ allocation...

Anatomical cardiac alterations in liver cirrhosis: An autopsy study

Background. It has been suggested that liver cirrhosis (LC), regardless of etiology, may be associated with anatomical cardiac alterations. Objective. To describe the frequency and type of macroscopical anatomic cardiac...

Effect of cirrhosis at baseline on the outcome of type 1 autoimmune hepatitis

Material and methods. With the aim of analyzing the influence of presence of cirrhosis at baseline on the outcome, we revised the evolution of a cohort of patients with type 1 autoimmune hepatitis, prospectively followed...

Download PDF file
  • EP ID EP78409
  • DOI -
  • Views 133
  • Downloads 0

How To Cite

Willem J. Lammers, Kris V. Kowdley, Henk R. van Buuren (2014). Predicting outcome in primary biliary cirrhosis. Annals of Hepatology, 13(4), 316-326. https://www.europub.co.uk/articles/-A-78409