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Clinical features and prognosis of primary biliary cirrhosis in Korea

Authors
Kim K.A.Jeong S.H.Lee J.I.Yeon J.E.Lee H.J.Kwon S.Y.Chang U.I.Min H.J.
Issue Date
2010
Keywords
Antimitochondrial antibody; Bilirubin; Alkaline phosphatase; Survival rate; 원발성 담즙성 간경변증; 자가면역 간질환; 예후 항미토콘드리아항체; 담즙정체
Citation
The Korean journal of hepatology, v.16, no.2, pp.139 - 146
Indexed
SCOPUS
KCI
Journal Title
The Korean journal of hepatology
Volume
16
Number
2
Start Page
139
End Page
146
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/15469
DOI
10.3350/kjhep.2010.16.2.139
ISSN
1738-222X
Abstract
BACKGROUND/AIMS: This study investigated the clinical features and prognosis of primary biliary cirrhosis (PBC) in Korea. METHODS: Clinical data of patients diagnosed as PBC between 1997 and 2008 at eight referral hospitals were analyzed retrospectively. PBC was diagnosed based on liver function tests, presence of serum antimitochondrial antibody (AMA), and histopathological findings. RESULTS: In total, 251 patients (218 females, 33 males; mean age 54 years) were enrolled, and the mean follow-up duration was 33.5 months. At the diagnosis, 61% of the patients were asymptomatic, 12% had decompensated liver cirrhosis, and 98% were positive for AMA. The serum alkaline phosphate (ALP) level was 2.6 times the upper limit of normal, aspartate aminotransferase was 105 U/L, and bilirubin was 2.0 mg/dL. The mean Mayo risk score was 5.5, and the Child-Pugh class was A, B, and C in 79%, 19%, and 2% of the patients, respectively. Ursodeoxycholic acid (UDCA) was used for treatment in 88% of the patients, among which 70% exhibited biochemical responses defined as normalization or a > 40% decrease in ALP at 6 months. Eight deaths occurred during the follow-up; the causes were variceal bleeding, hepatic failure, and sepsis. The overall 5-year survival rate was 95%. The poor prognostic factors were being older than 60 years, high bilirubin, low albumin, ascites, high Mayo risk score, Child-Pugh class C, and initial presence of hepatic decompensation. CONCLUSIONS: Most patients diagnosed as PBC were asymptomatic, and these patients had a favorable short-term prognosis. The prognosis of PBC was dependent on the initial severity of liver disease.
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Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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