Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process
Introduction and Objectives: Early diagnosis of primary biliary cholangitis (PBC) is fundamental, as treatment with ursodeoxycholic acid (UDCA) prevents its progression. The aim of our study is to investigate undiagnosed patients in our region and to treat retrieved patients. Patients and Methods: A...
Saved in:
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-07-01
|
| Series: | Annals of Hepatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268125001589 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849417482428743680 |
|---|---|
| author | Agustin Castiella Maria José Sánchez-Iturri Jon Stampa Beatriz Fernandez Iñigo Garaizabal Alvaro Prada Silvia Torrente Leire Aburruza Eva Zapata |
| author_facet | Agustin Castiella Maria José Sánchez-Iturri Jon Stampa Beatriz Fernandez Iñigo Garaizabal Alvaro Prada Silvia Torrente Leire Aburruza Eva Zapata |
| author_sort | Agustin Castiella |
| collection | DOAJ |
| description | Introduction and Objectives: Early diagnosis of primary biliary cholangitis (PBC) is fundamental, as treatment with ursodeoxycholic acid (UDCA) prevents its progression. The aim of our study is to investigate undiagnosed patients in our region and to treat retrieved patients. Patients and Methods: Analysis of databases (immunology, biochemistry and other data from their medical records) was performed between January 2019 and December 2021. PBC was diagnosed if anti-mitochondrial antibodies were positive (>1:80) and alkaline phosphatase (AP) was chronically elevated in the absence of other liver disease. Identified patients were contacted. Results: A total of 306 patients were identified and 221 had previously been diagnosed with PBC and were undergoing treatment.Fifty-one patients did not meet the current criteria for diagnosis and treatment at their last blood test. Six patients had died by the time the study started. Finally, we found 28 patients with a probable diagnosis of PBC who could benefit from treatment (9.6%).We contacted all 28 patients and 16 (57.14%) of them agreed to come to our hospital for diagnosis confirmation, ultrasound and fibroscan. All of them were women, aged between 46 and 74 years (mean 61.18, SD 9.19). Laboratory analysis showed a mean AP of 144.25 (SD 71.03) and mean GGPT of 115.62 (SD 98.42). Mean bilirubin was 0.55 (SD 0.22). Fibroscan showed a mean value of 6.05 kPa. UDCA was initiated in 14 patients; two patients refused treatment. Conclusions: The use of hospital databases enabled us to diagnose and treat 16 (57.14%) of the 28 detected patients. |
| format | Article |
| id | doaj-art-673a7761c7544547b7b22dc6a78128c6 |
| institution | Kabale University |
| issn | 1665-2681 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj-art-673a7761c7544547b7b22dc6a78128c62025-08-20T03:32:50ZengElsevierAnnals of Hepatology1665-26812025-07-0130210193310.1016/j.aohep.2025.101933Identifying patients with undiagnosed primary biliary cholangitis using a clinical management processAgustin Castiella0Maria José Sánchez-Iturri1Jon Stampa2Beatriz Fernandez3Iñigo Garaizabal4Alvaro Prada5Silvia Torrente6Leire Aburruza7Eva Zapata8Servicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, Spain; Corresponding author.Servicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainServicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainServicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainServicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainServicio Inmunologia, Hospital Universitario Donostia, Donostia, SpainServicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainServicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainServicio Aparato Digestivo, Hospital Universitario Donostia, Biogipuzkoa, Hospital Universitario Donostia, Donostia, SpainIntroduction and Objectives: Early diagnosis of primary biliary cholangitis (PBC) is fundamental, as treatment with ursodeoxycholic acid (UDCA) prevents its progression. The aim of our study is to investigate undiagnosed patients in our region and to treat retrieved patients. Patients and Methods: Analysis of databases (immunology, biochemistry and other data from their medical records) was performed between January 2019 and December 2021. PBC was diagnosed if anti-mitochondrial antibodies were positive (>1:80) and alkaline phosphatase (AP) was chronically elevated in the absence of other liver disease. Identified patients were contacted. Results: A total of 306 patients were identified and 221 had previously been diagnosed with PBC and were undergoing treatment.Fifty-one patients did not meet the current criteria for diagnosis and treatment at their last blood test. Six patients had died by the time the study started. Finally, we found 28 patients with a probable diagnosis of PBC who could benefit from treatment (9.6%).We contacted all 28 patients and 16 (57.14%) of them agreed to come to our hospital for diagnosis confirmation, ultrasound and fibroscan. All of them were women, aged between 46 and 74 years (mean 61.18, SD 9.19). Laboratory analysis showed a mean AP of 144.25 (SD 71.03) and mean GGPT of 115.62 (SD 98.42). Mean bilirubin was 0.55 (SD 0.22). Fibroscan showed a mean value of 6.05 kPa. UDCA was initiated in 14 patients; two patients refused treatment. Conclusions: The use of hospital databases enabled us to diagnose and treat 16 (57.14%) of the 28 detected patients.http://www.sciencedirect.com/science/article/pii/S1665268125001589Primary biliary cholangitisUndiagnosed patientsClinical management process |
| spellingShingle | Agustin Castiella Maria José Sánchez-Iturri Jon Stampa Beatriz Fernandez Iñigo Garaizabal Alvaro Prada Silvia Torrente Leire Aburruza Eva Zapata Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process Annals of Hepatology Primary biliary cholangitis Undiagnosed patients Clinical management process |
| title | Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process |
| title_full | Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process |
| title_fullStr | Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process |
| title_full_unstemmed | Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process |
| title_short | Identifying patients with undiagnosed primary biliary cholangitis using a clinical management process |
| title_sort | identifying patients with undiagnosed primary biliary cholangitis using a clinical management process |
| topic | Primary biliary cholangitis Undiagnosed patients Clinical management process |
| url | http://www.sciencedirect.com/science/article/pii/S1665268125001589 |
| work_keys_str_mv | AT agustincastiella identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT mariajosesancheziturri identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT jonstampa identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT beatrizfernandez identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT inigogaraizabal identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT alvaroprada identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT silviatorrente identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT leireaburruza identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess AT evazapata identifyingpatientswithundiagnosedprimarybiliarycholangitisusingaclinicalmanagementprocess |