부산대학교 도서관

This 53 year-old woman, who had consulted another hospital because of xanthelasma and been diagnosed morphologically as choiangiolitic hepatitis in 1969, was refered to our hospital for further examination in 1970. On the basis of clinical course and laboratory data, she was given a diagnosis of primary biliary cirrhosis and followed up thereafter for 7 years until died from hepatic coma. Serum total bilirubin had remained within 1.5mg/dl until 2.5 years before death when it began to increase. Serum total cholesterol, which was 318 mg/dl on admission, was lowered gradually to 200 mg/dl when jaundice appeared. The serum alkaline phosphatase (ALP) level remained high (10-15 Bessy unit/dl) until 6 months before death and dropped abruptly thereafter. Although morphological findings specific for PBC was not obtained by the needle biopsies, various changes in the inter-lobular bile ducts were revealed at necropsy in spite of the cirrhotic liver.In the patient with PBC, characteristic features on the laboratory data (i.e. elevation of serum total cholesterol and ALP, etc.) are seen in the early stage and diminished along the course of the disease. Therefor, the duration of the illness must be kept in mind for the evaluation of the laboratory data and the comparison with the initial value are necessary.Morphological stage diagnosis only from the biopsy is not desirable, because the changes of inter-lobular bile ducts in this disease are not uniform in phase throughout the liver as seen in this case.