Primary Biliary Cirrhosis- Diagnosis and Treatment

Primary biliary cirrhosis

is an autoimmune disease of the liver. It is a chronic disease where the small ducts within the liver area damaged in a slow progressive way. As a result, there is build up of bile in the liver and over time, this accumulation damages the liver tissue.


Bile is a bitter-tasting, dark yellowish brown fluid, produced by the liver. It travels through the bile ducts to the gall bladder and then to duodenum and small intestine. Bile helps digest fats and fat-soluble vitamins such as vitamin A, D, E and K.

In PBC, it is called primary because in this condition the ducts affected are small bile ducts within the liver. In secondary biliary cirrhosis, there is obstruction of bile in large bile ducts of the liver like the common bile duct and its major branches.

Diagnosis of PBC:

First step in diagnosis of PBC is blood test. Diagnostic blood tests include:

  • Deranged

    liver function tests

    like alkaline phosphatase blood test to see high alkaline phosphatase and elevated levels of AST and ALT.

  • Anti-mitochondrial antibody (AMA) blood test to see the presence of antibodies such as antimitochondrial antibody and antinuclear antibody.
  • Liver biopsy to determine the extent of liver damage. This is performed with a needle inserted between the ribs or into a vein in the neck.
  • Ultrasound and CT scan of abdomen usually done to differentially diagnose primary and secondary biliary cirrhosis.

Treatment of PBC:

In strict sense, PBC has

no cure.

Initial treatment aims at relieving the symptoms. Treatments like vitamin replacement therapy, calcium supplements and itching relieving medications are prescribed to cure the symptoms.

One specific drug that is prescribed for the condition is

Ursodiol (Actigall).

This is the only drug approved by the U.S. Food and Drug Administration for PBC treatment. This drug slows the progression time of the disease, thereby delaying liver failure.

In advanced cases of PBC, a liver transplant may be eventually needed. If the treatment is successful, it can result in a favorable prognosis of the disease.

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