A male case of asymptomatic primary bilary cirrhosis showed rapid deterioration of histological finding of the liver.

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A 52-year-old male was adrnitted for evaluatian of liver dysfunctian. Labaratary examinatian revealed elevation of serum levels of ALP, γ-GPT and LAP. But level of total bilirubin was within normal limit. Serum levels of IgG and IgM elevated and antimitochondrial antibody was positive. Liver biopsy showed chronic nonsuppurative destructive cholangitis, which was pathognamic as stage 1 of primary biliary cirrhosis (PBC). Because of no symptoms such as jaundice and itching, he had been managed at the outpatient clinic. After three and half years from the first admission, a cholecystectomy was performed for cholecystitis. Macroscopic finding of the liver during operation showed large nodular liver. Simultaneous needle biapsy of the liver showed portal-portal bridging formation by collagen fiber and pseudolobule formation. Because of the scarring of portal area was developing, the interlobular bile duct was obscure. These findings were compatible with stage 3 or 4 of PBC (Sheuer). It was suggested that this case was note-worthy for discussing prognosis of PBC and its histalagical course of the liver.
社団法人日本肝臓学会の論文