What are the possible complications of primary biliary cholangitis (PBC)?

Updated: Nov 08, 2017
  • Author: Nikolaos T Pyrsopoulos, MD, PhD, MBA, FACP, AGAF; Chief Editor: BS Anand, MD  more...
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Answer

The following complications may arise in patients with primary biliary cholangitis:

  • Osteoporosis resulting from a decreased formation of bone has been found in one third of patients.
  • Fat-soluble vitamin deficiency is a rare complication that is present in patients with long-standing hyperbilirubinemia.
  • Hypercholesterolemia and hyperlipidemia have been identified in 85% of patients.
  • Esophageal motility problems can occasionally occur, with asymptomatic or symptomatic reflux causing esophagitis and, possibly, stricture. This is more common in patients with CREST syndrome.
  • Patients with jaundice can develop steatorrhea. This complication results from the decreased excretion of bile acids. Mild pancreatic insufficiency has also been reported.
  • Renal tubular acidosis can be observed in approximately one half of patients with primary biliary cholangitis. Copper deposition in the renal tubules or an autoimmune phenomenon might be the mechanism for this complication.
  • Hypothyroidism has been noted in 20% of patients with primary biliary cholangitis.
  • Hepatocellular carcinoma can develop, with an overall incidence of approximately 6% (4.1% in women; 20% in men with advanced disease).
  • Asymptomatic bacteriuria has been found in 35% of patients with primary biliary cholangitis.
  • Autoimmune thrombocytopenia and hypoglycemia with insulin receptor autoantibodies may occur.
  • Transverse myelitis and necrotizing myelopathy caused by vasculitis may occur.
  • Xanthomatous peripheral neuropathy may occur.

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