Complications

Complication
Timeframe
Likelihood
long term
high

Elevated total cholesterol levels are common in PBC. The implications of elevated cholesterol levels are, however, less clear-cut in patients with PBC than in the broader population, because of the contribution made by lipoprotein X (which reduces the atherogenicity of low-density lipoprotein) to total cholesterol levels.[37]​ There is no substantial evidence to support an elevated cardiovascular risk in patients with PBC and raised cholesterol.[14]

Where appropriate the use of statins appears to be safe in PBC.[14][15]

Hypercholesterolaemia

long term
medium

Significantly greater risk of osteopenia and osteoporosis in PBC.[14] Overall, osteoporosis is common in people with PBC because of the demographic distribution of the disease (predominantly postmenopausal women) and the effect of cholestasis on vitamin D and calcium absorption. Management is the same as for osteoporosis of other aetiologies.[14]

Osteoporosis

long term
low

Complication of cirrhosis in patients progressing to end-stage disease. Major manifestations are ascites, splenomegaly, and variceal bleeding.[71] Non-cirrhotic portal hypertension can also be seen in PBC.

Management is the same as for cirrhosis of other causes.

Cirrhosis

long term
low

Complication of cirrhosis in patients progressing to end-stage disease. More common in male than female patients.[72]

Management is the same as for hepatocellular carcinoma of other aetiologies.

Hepatoma

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