Primary%20biliary%20cholangitis Signs and Symptoms

Signs and Symptoms

Introduction

Primary biliary cholangitis (PBC) is an autoimmune disease of a chronic and progressive nature, characterized by destruction of small to medium bile ducts, leading to cholestasis and frequently, end-stage liver disease
- Diagnostic features of PBC are the chronic biochemical cholestasis, presence of antimitochondrial antibodies (AMA) and the characteristic liver biopsy findings
Suggested to have environmental and/or genetic factors affecting its development
PBC is more common in Northern Europeans and the majority of the patients are middle-aged women
- Men with the disease are more likely to develop hepatocellular carcinoma (HCC)

Signs and Symptoms

Fatigue

The most common symptom seen in 50-78% of patients
Associated with depression, obsessive-compulsive disorder and sleep disturbances
Symptom does not correlate with severity of liver disease

Pruritus

Prevalence rate is 20-70% in patients with PBC
A circadian rhythm may be noted with worse symptoms at night
May be so severe as to cause severe emotional disturbance
May be present even in patients with good liver function
Declines in severity with time from diagnosis

Jaundice

Present in 10-60% of patients due to cholestasis

Right Upper Quadrant Pain

Occurs in 8-17% of patients

Nephrologists’ insights: Why give TAF to chronic HBV patients in renal clinics?

Dr. Desmond Yap, Dr. Benjamin So, 31 Jan 2023

Chronic hepatitis B (CHB) and its treatments are both risk factors for chronic kidney disease (CKD), especially in the face of cardiometabolic comorbidities and in patients of advanced age. In an interview with MIMS Doctor, Dr Desmond Yap of the Division of Nephrology, University of Hong Kong and Dr Benjamin So of the Division of Nephrology, Queen Mary Hospital, discussed how hepatitis B virus (HBV) infection and certain nucleos(t)ide analogues (NAs) may potentially affect kidney function, and how to better manage CHB patients in renal clinics, including those with CKD and kidney transplant recipients (KTRs).

HCV pangenotypic DAA therapy in a patient with concomitant antipsychotic treatment

Dr. Ting-Ting Chan, 27 Oct 2023

A 43-year-old male former intravenous drug user presented with incidental findings of elevated alanine transaminase (ALT) levels in December 2021. The patient had depression and drug-induced psychosis associated with previous heroin, ketamine and methamphetamine use. He was on quetiapine 300 mg daily for his psychotic symptoms, pantoprazole 40 mg daily as needed for occasional acid reflux, and simvastatin 10 mg daily for hyperlipidaemia. He did not have hepatitis B virus (HBV) or human immunodeficiency virus (HIV) coinfection.

Reducing risks and improving long-term outcomes in patients with CHB

Prof. Vincent Wong, Prof. Ray Kim, Dr. Tan Poh Seng, 10 Sep 2019

Chronic hepatitis B (CHB) remains a major public health concern because of its worldwide distribution and potential adverse sequelae, including cirrhosis and hepatocellular carcinoma (HCC). At a recent symposium held during the GIHep Singapore 2019, Professor Vincent Wong from the Chinese University of Hong Kong and Professor Ray Kim from the Stanford University School of Medicine, Stanford, California, US, discussed antiviral treatments for CHB, with a focus on the novel agent tenofovir alafenamide (Vemlidy®). Dr Tan Poh Seng from the National University Hospital, Singapore, chaired the symposium.