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{{Primary biliary cirrhosis}}
{{Primary biliary cirrhosis}}


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==Overview==
==Overview==
Physical examination of patients with primary biliary cirrhosis in early stages of diseases is usually normal. Patients have clinical manifestations as the disease progress. Physical examination of patients with primary biliary cirrhosis is usually remarkable for [[fatigue]]. Late stage disease is characterized by [[liver failure]] manifesting as [[abdominal distension]] and [[altered mental status]].


==Physical Examination==
==Physical Examination==
On physical examination, the following may be present
 
*Physical examination of patients with primary biliary cirrhosis in early stages of diseases is usually normal. Patients have clinical manifestations as the disease progress.<ref name="pmid18215315">{{cite journal| author=Kumagi T, Heathcote EJ| title=Primary biliary cirrhosis. | journal=Orphanet J Rare Dis | year= 2008 | volume= 3 | issue=  | pages= 1 | pmid=18215315 | doi=10.1186/1750-1172-3-1 | pmc=2266722 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18215315  }} </ref><ref name="pmid25954476">{{cite journal| author=Purohit T, Cappell MS| title=Primary biliary cirrhosis: Pathophysiology, clinical presentation and therapy. | journal=World J Hepatol | year= 2015 | volume= 7 | issue= 7 | pages= 926-41 | pmid=25954476 | doi=10.4254/wjh.v7.i7.926 | pmc=4419097 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25954476  }} </ref>
 
===Appearance of the Patient===
*Patients with primary biliary cirrhosis may appear [[fatigued]].<ref name="pmid20683955">{{cite journal| author=Al-Harthy N, Kumagi T, Coltescu C, Hirschfield GM| title=The specificity of fatigue in primary biliary cirrhosis: evaluation of a large clinic practice. | journal=Hepatology | year= 2010 | volume= 52 | issue= 2 | pages= 562-70 | pmid=20683955 | doi=10.1002/hep.23683 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20683955  }} </ref><ref name="pmid9824355">{{cite journal| author=Cauch-Dudek K, Abbey S, Stewart DE, Heathcote EJ| title=Fatigue in primary biliary cirrhosis. | journal=Gut | year= 1998 | volume= 43 | issue= 5 | pages= 705-10 | pmid=9824355 | doi= | pmc=1727314 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9824355  }} </ref>
 
===Vital Signs===
* Vital signs of patients with primary biliary cirrhosis are usually normal.


===Skin===
===Skin===
*[[Xanthelasma]]ta (focal collections of [[cholesterol]] in the skin, especially around the eyes)
*[[Jaundice]]
*Diffuse [[pigmentation]] due to [[melanin]] deposition as a result of cholestasis
*Scratch marks
*[[Xanthelasma]] in a few patients
*[[Xanthomas]] are observed rarely
 
===HEENT===
* HEENT examination of patients with primary biliary cirrhosis is usually normal.
 
===Neck===
* Neck examination of patients with primary biliary cirrhosis is usually normal.
 
===Lungs===
* Pulmonary examination of patients with primary biliary cirrhosis is usually normal.
 
===Heart===
* Cardiac examination of patients with primary biliary cirrhosis is usually normal.


===Abdomen===
===Abdomen===
* Complications of [[cirrhosis]] and [[portal hypertension]]:
*[[Splenomegaly]] due to [[portal hypertension]]
**[[Esophageal varices]]
*[[Hepatomegaly]]
** Fluid retention in the abdomen ([[ascites]])
*[[Abdominal distension]] due to [[ascites]]


===Neurologic===
===Back===
* Complications of [[cirrhosis]] and [[portal hypertension]]:
Back examination of patients with primary biliary cirrhosis is usually normal.
** [[Hepatic encephalopathy]], up to coma, in extreme cases.
 
===Genitourinary===
* Genitourinary examination of patients with primary biliary cirrhosis is usually normal.
 
===Neuromuscular===
*[[Altered mental status]] due to [[hepatic encephalopathy]] in late stages
 
===Extremities===
* Extremity examination of patients with primary biliary cirrhosis is usually normal.


==References==
==References==
{{reflist|2}}
{{Reflist|2}}
 
{{WH}}
{{WS}}


[[Category:Gastroenterology]]
[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Hepatology]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Needs overview]]
[[Category:Rheumatology]]
 
[[Category:Medicine]]
{{WH}}
[[Category:Up-To-Date]]
{{WS}}

Latest revision as of 23:49, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]

Overview

Physical examination of patients with primary biliary cirrhosis in early stages of diseases is usually normal. Patients have clinical manifestations as the disease progress. Physical examination of patients with primary biliary cirrhosis is usually remarkable for fatigue. Late stage disease is characterized by liver failure manifesting as abdominal distension and altered mental status.

Physical Examination

  • Physical examination of patients with primary biliary cirrhosis in early stages of diseases is usually normal. Patients have clinical manifestations as the disease progress.[1][2]

Appearance of the Patient

Vital Signs

  • Vital signs of patients with primary biliary cirrhosis are usually normal.

Skin

HEENT

  • HEENT examination of patients with primary biliary cirrhosis is usually normal.

Neck

  • Neck examination of patients with primary biliary cirrhosis is usually normal.

Lungs

  • Pulmonary examination of patients with primary biliary cirrhosis is usually normal.

Heart

  • Cardiac examination of patients with primary biliary cirrhosis is usually normal.

Abdomen

Back

Back examination of patients with primary biliary cirrhosis is usually normal.

Genitourinary

  • Genitourinary examination of patients with primary biliary cirrhosis is usually normal.

Neuromuscular

Extremities

  • Extremity examination of patients with primary biliary cirrhosis is usually normal.

References

  1. ↑ Kumagi T, Heathcote EJ (2008). "Primary biliary cirrhosis". Orphanet J Rare Dis. 3: 1. doi:10.1186/1750-1172-3-1. PMC 2266722. PMID 18215315.
  2. ↑ Purohit T, Cappell MS (2015). "Primary biliary cirrhosis: Pathophysiology, clinical presentation and therapy". World J Hepatol. 7 (7): 926–41. doi:10.4254/wjh.v7.i7.926. PMC 4419097. PMID 25954476.
  3. ↑ Al-Harthy N, Kumagi T, Coltescu C, Hirschfield GM (2010). "The specificity of fatigue in primary biliary cirrhosis: evaluation of a large clinic practice". Hepatology. 52 (2): 562–70. doi:10.1002/hep.23683. PMID 20683955.
  4. ↑ Cauch-Dudek K, Abbey S, Stewart DE, Heathcote EJ (1998). "Fatigue in primary biliary cirrhosis". Gut. 43 (5): 705–10. PMC 1727314. PMID 9824355.

Template:WH Template:WS

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