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Titolo:
TREATMENT OF PRIMARY BILIARY-CIRRHOSIS
Autore:
HEATHCOTE J;
Indirizzi:
UNIV TORONTO,TORONTO HOSP,GEN DIV,200 ELIZABETH ST TORONTO ON M5G 2C4CANADA
Titolo Testata:
Journal of gastroenterology and hepatology
fascicolo: 7, volume: 11, anno: 1996,
pagine: 605 - 609
SICI:
0815-9319(1996)11:7<605:TOPB>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
URSODEOXYCHOLIC ACID THERAPY; CONTROLLED TRIAL; LIVER-TRANSPLANTATION; RANDOMIZED TRIAL; DOUBLE-BLIND; MULTICENTER; PROGNOSIS; EFFICACY; PRURITUS; DISEASE;
Keywords:
LIVER TRANSPLANTATION; PREVENTATIVE THERAPY; PRIMARY BILIARY CIRRHOSIS; SYMPTOMATIC TREATMENT; URSODEOXYCHOLIC ACID;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
J. Heathcote, "TREATMENT OF PRIMARY BILIARY-CIRRHOSIS", Journal of gastroenterology and hepatology, 11(7), 1996, pp. 605-609

Abstract

Primary biliary cirrhosis (PBC) is a slowly progressive chronic cholestatic disease of the liver thought to be caused by immune destructionof the interlobular bile ducts. One-third of patients are asymptomatic and one-third of these develop symptoms within 5 years. Therapeutic regimens should be directed at the control of symptoms, prevention of complications and specific therapy aimed at controlling progression ofthe disease. Symptoms may be secondary to cholestasis or due to otherassociated diseases. The cause of pruritus secondary to cholestasis remains unknown; the anion exchange resin cholestyramine generally brings relief. In patients resistant or intolerant to this therapy, rifampin may be helpful, as well as ultraviolet light without sunblock. Liver transplantation may rarely be the only option for uncontrollable pruritus. Clinical manifestations of keratoconjunctivitis sicca and xerostomia need constant attention to prevent corneal ulcers and dental caries. Preventative therapy includes regular screening for thyroid dysfunction and replacement therapy when necessary and the administration of the fat soluble vitamins A, D and It once hyperbilirubinaemia is present. Osteoporosis is a complication of all cholestatic liver disease. There is no satisfactory preventative therapy. It may be appropriate to give hormone replacement therapy to all post-menopausal women with PBC to reduce osteoporosis. Liver transplantation is the best option for those with fractures. Oesophageal varices may develop early in the course of PBC, non-selective beta-blocker therapy should be used as prophylaxis against variceal haemorrhage. The only specific therapy shown to cause both a biochemical and survival benefit in patients with PBC is ursodeoxycholic acid (UDCA). Treatment with UDCA delays progression, but does not result in a cure of this disease. Currently, liver transplantation is the only definitive treatment available for end-stagedisease.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 30/11/20 alle ore 06:53:04