Primary Biliary Cirrhosis (cont.)
In this Article
Rheumatoid arthritis
An abnormal type of antibody, called rheumatoid factor, is found in the blood
of most patients with rheumatoid arthritis. This antibody also is found,
however, in approximately 25% of patients with PBC. Although some PBC patients
with the rheumatoid factor also have symptoms of joint pain and stiffness, most
do not.
Celiac sprue
This autoimmune disease of the gut occurs in about 6% of patients with PBC.
The disease impairs intestinal absorption of dietary fat and other nutrients,
resulting in diarrhea and nutritional and vitamin deficiencies. Celiac sprue is
caused by intolerance to gluten, a component of wheat, barley, and rye in the
diet. As already mentioned, similar symptoms can occur in PBC itself as a result
of fat malabsorption due to decreased bile flow into the gut. In any case, PBC
patients with the signs or symptoms of fat malabsorption should be tested for
celiac sprue. The diagnosis of celiac sprue is made by finding certain serum
antibodies (for example, those called antigliadin or antiendomysial antibodies),
characteristic intestinal biopsy features, and a usually dramatic response to
dietary restriction of gluten.
Urinary tract infections
Recurrent bacterial infections of the urine occur in 19% of women with PBC.
These infections may be without symptoms or cause a sense of a frequent, urgent
need to urinate with a burning feeling while passing urine.
Gallstones
Patients with PBC can develop two types of gallstones in the gallbladder. One
type (called cholesterol gallstones) contains mostly cholesterol, and is by far
the most common type of gallstone found in the general population. The other
type (called pigment gallstones) contains mostly bile pigments (including
bilirubin) and calcium. This type of gallstone occurs with increased frequency
in all types of cirrhosis, including PBC.
Gallstones occur in about 30% of adults in the general population and are at
least twice as common in women as in men. It is not surprising, therefore, that
gallstones are especially frequent in individuals having other conditions that
tend to afflict women more than men, such as PBC. The most common symptom of
gallstones is abdominal pain. Sometimes, they can cause nausea, fever, and/or
jaundice. But the majority of gallstones do not cause any symptoms. The
diagnosis of gallstones is usually made by ultrasound imaging of the
gallbladder.
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