Case Report of Primary Biliary Cirrhosis with Normal Alkaline Phosphatase
Author Information
Author(s): Joshua M Brostoff, Sukaina Rashid, Daniel McCrea
Primary Institution: Central Middlesex Hospital, London, UK
Hypothesis
Can primary biliary cirrhosis manifest without elevated alkaline phosphatase levels?
Conclusion
This case demonstrates that primary biliary cirrhosis can occur with normal alkaline phosphatase levels, highlighting the need for a high index of suspicion.
Supporting Evidence
- Patient presented with abdominal swelling and fatigue.
- Anti-mitochondrial antibodies were strongly positive.
- Gamma-glutamyl transferase was elevated despite normal alkaline phosphatase.
Takeaway
A 78-year-old woman had liver disease without the usual signs, showing that doctors need to look for other clues to diagnose it.
Methodology
Case report detailing the patient's symptoms, laboratory findings, and diagnosis.
Limitations
The patient was diagnosed at an older age than typical for PBC, and a liver biopsy was not performed due to her frailty.
Participant Demographics
78-year-old lady of West Indian origin.
Digital Object Identifier (DOI)
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