The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Vol 20, No 3 (2019): VOLUME 20, NUMBER 3, December 2019

Clinical, Molecular, and Histopathological Aspect of Primary Biliary Cholangitis

Flora Dameria (Department of Anatomical Pathology Residency Program, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta)
Marini Stephanie (Division od Gastroentero-hepatobilliary Pathology, Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta)
Ria Kodariah (Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia)
Diah Rini Handjari (Division od Gastroentero-hepatobilliary Pathology, Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta)
Ening Krisnuhoni (Division od Gastroentero-hepatobilliary Pathology, Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta)
Nur Rahadiani (Division od Gastroentero-hepatobilliary Pathology, Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia/Dr. Cipto Mangunkusumo National General Hospital, Jakarta)



Article Info

Publish Date
23 Jul 2020

Abstract

Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease which tends to be chronic and progressive in nature that is marked by the presence of cholangitis and small size biliary duct destruction which may cause cirrhosis or even liver failure. PBC incidence increases because PBC can now be diagnosed earlier and is due to the increasing survival rate of PBC patients. Diagnosis of PBC can be confirmed in asymptomatic state if in the indirect immunofluorescence (IIF) examination revealed AMA positive, and there is an abnormal liver function. Etiopathogenesis of PBC is multifactorial which involves genetic and environmental factors. Genetic factors which contribute to the incidence of PBC are HLA and non-HLA genes, while in the environmental factors, the triggering factors of PBC are bacterial infection and xenobiotic. Interaction of these factors causes the development of E2 subunit pyruvate dehydrogenase complex (PDC-E2) and antimitochondrial antibody (AMA) as the causing autoantigen of biliary duct desctruction in PBC, mediated by the immune system. PBC stage is divided into minimal, mild, moderate and severe. Ursodeoxycholic acid (UDCA) is the first line therapy for PBC, while obeticholic acid (OCA) and fibrate is used as the second line. Liver transplantation is the definitive therapy for PBC where disease progresses into the advanced stage, although the patients have received medical treatment.

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Journal Info

Abbrev

jghe

Publisher

Subject

Medicine & Pharmacology

Description

The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy is an academic journal which has been published since 2000 and owned by 3 Societies: The Indonesian Society of Gastroenterology; Indonesian Association for the Study of the Liver; The Indonesian Society for Digestive ...