2016
DOI: 10.1093/gastro/gov064
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Subtle presentation of active primary biliary cirrhosis in chronic hepatitis B: a case report

Abstract: We are describing an interesting case of two chronic liver diseases in a 48-year-old Chinese woman. While chronic hepatitis B is a common entity in Asia, the patient was later found to have active, asymptomatic primary biliary cirrhosis due to a persistently elevated alkaline phosphatase level after optimal hepatitis B virus DNA suppression on antiviral therapy. This report emphasizes the importance of keeping a high index of suspicion for another potential liver disease process even after a patient has been s… Show more

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Cited by 2 publications
(5 citation statements)
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“…Cholestasis in NAFLD patients is associated with more pronounced liver injury, inflammation, and disturbances in glucose and lipid metabolism contributing to the progressive course of NAFLD [ 37 ]. Clinical studies reported that primary biliary fibrosis and biliary atresia occurred in patients with HBV infection [ 38 , 39 ]. Similarly, biliary diseases might even be attributed to or caused by HBV infection [ 39 ].…”
Section: Discussionmentioning
confidence: 99%
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“…Cholestasis in NAFLD patients is associated with more pronounced liver injury, inflammation, and disturbances in glucose and lipid metabolism contributing to the progressive course of NAFLD [ 37 ]. Clinical studies reported that primary biliary fibrosis and biliary atresia occurred in patients with HBV infection [ 38 , 39 ]. Similarly, biliary diseases might even be attributed to or caused by HBV infection [ 39 ].…”
Section: Discussionmentioning
confidence: 99%
“…Clinical studies reported that primary biliary fibrosis and biliary atresia occurred in patients with HBV infection [ 38 , 39 ]. Similarly, biliary diseases might even be attributed to or caused by HBV infection [ 39 ]. We have reported earlier that HBs can enhance cholestatic liver injury, fibrosis, and tumorigenesis in Abcb4 knockout mice [ 23 ].…”
Section: Discussionmentioning
confidence: 99%
“…A study in Taiwan showed that, among 76 patients with PBC, 9 cases were confirmed as having a coexistence of HCV infection and PBC, and suffered from more serious hepatic cirrhosis on the basis of Child-Pugh ( P = 0.019) and the Model for End-Stage Liver Disease (MELD) ( P = 0.01) scores[72]. One case report showed that a patient with chronic HBV infection was later found to have active, asymptomatic PBC due to a persistently elevated ALP level after optimal HBV DNA suppression on antiviral therapy[73]. This report emphasizes the significance of keeping a high clinical index of suspicion for potential PBC, even after a patient with HBV has been successfully treated for a primary liver condition[73].…”
Section: Fat-soluble Vitamin Deficiencymentioning
confidence: 99%
“…One case report showed that a patient with chronic HBV infection was later found to have active, asymptomatic PBC due to a persistently elevated ALP level after optimal HBV DNA suppression on antiviral therapy[73]. This report emphasizes the significance of keeping a high clinical index of suspicion for potential PBC, even after a patient with HBV has been successfully treated for a primary liver condition[73]. Clinical vigilance, particularly in atypical clinical manifestations, can result in earlier accurate diagnosis and prompt treatment of PBC[73].…”
Section: Fat-soluble Vitamin Deficiencymentioning
confidence: 99%
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