Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines
Primary biliary cholangitis (PBC) is an autoimmune cholangiopathy that affects mainly women and, if untreated, can evolve into biliary cirrhosis. Its prevalence varies worldwide, depending on race, and accounts for 22.27 cases/100,000 habitants in Europe. To establish the diagnosis of PBC according...
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Open Exploration
2024-01-01
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| author | Matteo Biagi Elisa Bernasconi Carmela Cursaro Enrico Ronconi Filippo Zanni Pamela Sighinolfi Pietro Andreone |
| author_facet | Matteo Biagi Elisa Bernasconi Carmela Cursaro Enrico Ronconi Filippo Zanni Pamela Sighinolfi Pietro Andreone |
| author_sort | Matteo Biagi |
| collection | DOAJ |
| description | Primary biliary cholangitis (PBC) is an autoimmune cholangiopathy that affects mainly women and, if untreated, can evolve into biliary cirrhosis. Its prevalence varies worldwide, depending on race, and accounts for 22.27 cases/100,000 habitants in Europe. To establish the diagnosis of PBC according to the European Association for the Study of the Liver (EASL) guidelines, two criteria must be satisfied among alkaline phosphatase (ALP) alterations, autoantibody positivity, and histologic abnormalities. Early treatment is effective in prolonging survival. Current guidelines do not suggest hepatic biopsy in patients with autoantibody positivity without cholestasis alterations. However, many patients with these characteristics have been diagnosed with PBC disease only histologically, mainly patients with normal ALP and elevated gamma-glutamyl transferase (GGT), whose normalization has been used as a marker for the follow-up. In contrast, this is the case of a patient with autoantibody positivity and both ALP and GGT within the range, diagnosed for PBC by histology. The manuscript wants to propose the re-evaluation of the role of liver biopsy in PBC diagnosis and the need for a serological or histological biomarker in the follow-up of patients without cholestatic alterations. |
| format | Article |
| id | doaj-art-e447bcf59e83451892171ff4ecb88c2b |
| institution | Kabale University |
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| language | English |
| publishDate | 2024-01-01 |
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| spelling | doaj-art-e447bcf59e83451892171ff4ecb88c2b2025-02-08T03:44:56ZengOpen ExplorationExploration of Drug Science2836-76772024-01-01211510.37349/eds.2024.00033Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelinesMatteo Biagi0https://orcid.org/0000-0002-5074-9197Elisa Bernasconi1Carmela Cursaro2Enrico Ronconi3Filippo Zanni4Pamela Sighinolfi5Pietro Andreone6https://orcid.org/0000-0002-4794-9809Department of Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyDepartment of Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyDepartment of Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyDepartment of Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyDepartment of Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyDepartment of Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyDepartment of Internal Medicine, General, Emergency and Post-Acute, Division of Metabolic Internal Medicine, Civil Hospital of Baggiovara, Azienda Ospedaliero-Universitaria di Modena, 41126 Modena, ItalyPrimary biliary cholangitis (PBC) is an autoimmune cholangiopathy that affects mainly women and, if untreated, can evolve into biliary cirrhosis. Its prevalence varies worldwide, depending on race, and accounts for 22.27 cases/100,000 habitants in Europe. To establish the diagnosis of PBC according to the European Association for the Study of the Liver (EASL) guidelines, two criteria must be satisfied among alkaline phosphatase (ALP) alterations, autoantibody positivity, and histologic abnormalities. Early treatment is effective in prolonging survival. Current guidelines do not suggest hepatic biopsy in patients with autoantibody positivity without cholestasis alterations. However, many patients with these characteristics have been diagnosed with PBC disease only histologically, mainly patients with normal ALP and elevated gamma-glutamyl transferase (GGT), whose normalization has been used as a marker for the follow-up. In contrast, this is the case of a patient with autoantibody positivity and both ALP and GGT within the range, diagnosed for PBC by histology. The manuscript wants to propose the re-evaluation of the role of liver biopsy in PBC diagnosis and the need for a serological or histological biomarker in the follow-up of patients without cholestatic alterations.https://www.explorationpub.com/uploads/Article/A100833/100833.pdfprimary biliary cholangitisalkaline phosphataseliver histologyguidelines |
| spellingShingle | Matteo Biagi Elisa Bernasconi Carmela Cursaro Enrico Ronconi Filippo Zanni Pamela Sighinolfi Pietro Andreone Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines Exploration of Drug Science primary biliary cholangitis alkaline phosphatase liver histology guidelines |
| title | Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines |
| title_full | Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines |
| title_fullStr | Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines |
| title_full_unstemmed | Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines |
| title_short | Histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations: a case report that escaped guidelines |
| title_sort | histological diagnosis of primary biliary cholangitis in one patient without cholestasis alterations a case report that escaped guidelines |
| topic | primary biliary cholangitis alkaline phosphatase liver histology guidelines |
| url | https://www.explorationpub.com/uploads/Article/A100833/100833.pdf |
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