What are the symptoms of primary biliary cirrhosis

Biliary cirrhosis is a common hepatobiliary disease. It is most common among women aged 40-60. The disease is hidden and the onset is very slow. And biliary cirrhosis can be divided into primary and secondary. Biliary cirrhosis is primary due to long-term retention of bile in the liver. Biliary cirrhosis caused by extrahepatic bile duct obstruction is secondary.

1. Early days

The only symptoms were mild fatigue and intermittent itching. Half of the patients had hepatomegaly and one quarter had splenomegaly. Elevated serum alkaline phosphatase and γ-GT were often the only positive findings. Pruritus that was mild during the day and severe at night was the first symptom in 47%. One-quarter of patients first experience fatigue, which may lead to depression, followed by itching. Jaundice is the first symptom in 13% of cases. Such patients often have hepatosplenomegaly, yellow warts, corneal pigmented rings, liver palms, spider nevi, butterfly-shaped skin pigmentation spots at the scratched sites, and coarsening and thickening of the skin, which may be related to scratches and vitamin A deficiency.

2. Anicteric period

A small number of patients may have serum cholesterol as high as 8g/L, with nodular yellow warts on the palms, soles, chest and back skin, as well as along the knees, elbows, gluteal tendons, and nerve sheaths. Finger clubbing and long bone periostitis may be accompanied by pain and tenderness.

3. Jaundice stage

The appearance of clinical jaundice marks the beginning of the jaundice period. The deepening of jaundice indicates that the disease has progressed to the late stage and the life expectancy is less than 2 years. It is often accompanied by osteoporosis, osteomalacia, vertebral compression, and even rib and long bone fractures, which are related to vitamin D metabolism disorders.

4. Terminal stage

Serum bilirubin rose sharply, the liver and spleen were significantly enlarged, and itching and fatigue increased. The signs of chronic liver disease are becoming more severe, and the number of patients with esophageal varicose vein bleeding and ascites is increasing. Due to copper deposition, corneal pigment rings may be seen in a few cases. Due to the lack of bile salts in the intestinal cavity, fat emulsification and absorption are poor, and steatorrhea may occur. At this time, vitamins A, D, and K are poorly absorbed, which may cause night blindness, skin keratinization, bone changes, and coagulation mechanism disorders. Cholangiography showed that the large bile ducts were normal and the small bile ducts were tortuous. Finally, liver failure, varicose vein rupture, hepatic encephalopathy, ascites, edema and profound jaundice are often the terminal manifestations.

Concomitant diseases and their related manifestations: 2/3 have connective tissue diseases, autoimmune thyroiditis is also common, and may also be accompanied by scleroderma, calcification, Raynaud's phenomenon, 75% have keratoconjunctivitis sicca, 35% have asymptomatic bacteriuria, hypertrophic osteoarthropathy, 1/3 have pigmented gallstones, and may also have membranous glomerulonephritis and renal tubular acidosis.

Note: Everyone should pay attention to the early symptoms of primary biliary cirrhosis. Once discovered, timely treatment should be sought. In addition, more attention should be paid to the daily diet. A light diet should be adopted, and foods high in cholesterol and fat should be avoided. And you have to quit smoking and drinking.