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Primary Biliary Cirrhosis (cont.)

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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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Primary Biliary Cirrhosis - Symptoms Experienced

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