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Primær biliær kolangitt

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Definisjon:
En autoimmun, kronisk, kolestatisk sykdom i de intrahepatiske galleganger med inflammasjon, fibrose og risiko for å utvikle leversvikt. Sykdommen ble tidligere kalt primær biliær cirrhose.
Forekomst:
Sjelden. Prevalens ca. 100-400 per million.
Symptomer:
Tidlige tegn er slapphet, plagsom kløe og uforklarlig hyperlipidemi
Funn:
Hepatosplenomegali, hyperpigmentering, xantomatøse lesjoner kan forekomme. Ikterus eventuelt, men er et sent innsettende tegn.
Diagnostikk:
Biokjemiske prøver viser kolestatisk mønster. Andre årsaker til kolestase bør utelukkes. Anti-mitokondrie-antistoffer har høy sensitivitet og spesifisitet.
Behandling:
Ursodeoksykolsyre (UDCA)er førstevalg. Obetikolsyre kan brukes som alternativ eller i kombinasjon med UDCA. For øvrig behandling av komorbide tilstander og symptomatisk behandling. Levertransplantasjon ved utvikling av leversvikt.
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  • Peter D. Jost, spesialist i allmennmedisin, redaktør NEL, Trondheim

Tidligere fagmedarbeidere

  • Eiliv Brenna, overlege, Medisinsk avdeling, Regionsykehuset i Trondheim
  • Svein Ødegaard, overlege og professor, Haukeland sykehus og Nasjonalt senter for gastroenterologisk ultrasonografi, Bergen