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QJM Advance Access originally published online on April 8, 2005
QJM 2005 98(5):331-336; doi:10.1093/qjmed/hci058
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© The Author 2005. Published by Oxford University Press on behalf of the Association of Physicians. All rights reserved. For Permissions, please email: journals.permissions@oupjournals.org

Review

The natural history of asymptomatic primary biliary cirrhosis

J. Kurtovic1, S.M. Riordan1 and R. Williams2

From the 1Gastrointestinal and Liver Unit, The Prince of Wales Hospital and University of New South Wales, Sydney, Australia and 2Institute of Hepatology, University College London, London, UK

Address correspondence to A/Professor S.M. Riordan, Gastrointestinal and Liver Unit, The Prince of Wales Hospital, Barker Street, Randwick 2031, New South Wales, Australia. email: riordans@sesahs.nsw.gov.au

The first 150 words of the full text of this article appear below.


   Introduction
 
Appreciation of the spectrum of clinical features of primary biliary cirrhosis (PBC) has evolved considerably over the past few decades. Although the substantial female predominance documented in early series remains true today, it has become clear that other so called ‘classical’ clinical features, such as symptoms of jaundice, pruritis and fatigue, and even biochemical markers of cholestasis, need not necessarily be present. Only a small minority of patients nowadays present with liver failure and most are even identified while asymptomatic, with up to 80% of patients in recently reported series having no PBC-related symptoms at the time of diagnosis, compared to only 4% some 30 years ago (Table 1).1–7 The diagnosis of PBC in asymptomatic patients is usually established after the chance finding of an abnormal physical sign, such as hepatomegaly, or, more often, an elevated serum alkaline phosphatase level during the course of an unrelated illness. Alternatively, . . . [Full Text of this Article]


   Prevalence
 

   Natural history
 

   Factors influencing progression
 

   Survival
 

   Conclusions
 

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