VLD 421: Veterinary Clinical Biochemistry and Laboratory Diagnosis-II (0+1)

BILIARY CIRRHOSIS

Definition

• Biliary Cirrhosis is a disorder affecting bile secretion from the liver.

Cause

• There are two types of biliary cirrhosis:
• Primary Biliary Cirrhosis: (PBC) (Probably autoimmune)
• A disorder in which, the liver’s bile ducts are destroyed by a poorly understood process.
• Secondary Biliary Cirrhosis
• A disorder in which the bile ducts are destroyed due to prolonged obstruction of the biliary tree.
• Causes include gallstones in the common bile duct and chronic pancreatitis.

Diagnosis

• Primary Biliary Cirrhosis: (PBC)
• In blood, an elevated alkaline phosphatase measurements is noted.
• Cholesterol levels are usually high and there may be fatty deposits under the skin (xanthomas).
• Osteomalacia or osteoporosis may develop, probably related to malabsorption of Vit- D and calcium.
• Itching (pruritus), possibly related to increased deposition of bile salts in the skin.
• Other symptoms include jaundice, darkened urine, pale stools, and darkening of the skin.
• Liver function tests can confirm the presence of liver cell abnormality.
• Secondary Biliary Cirrhosis
• As with primary biliary cirrhosis, symptoms are related to bile duct obstruction and include itching, jaundice, and fatty stools.
• Bone disease may develop.
• Since secondary biliary cirrhosis follows long-standing bile duct disease, ultrasound may reveal enlargement of the ducts of the biliary system(extra-hepatic obstruction).
• Male/Female Differences
• For unknown reasons, primary biliary cirrhosis occurs most frequently in middle-aged women.
• Ninety percent of patients are female.