Most common symptom of primary biliary cirrhosis is

Answer is A (Pruritis): 'The earliest symptom is 'pruiritis' which may be either generalized or limited initially to the plams and soles.' -- Harrison Primary Biliary Cirrhosis Primary biliary cirrhosis is a disease characterized by chronic inflammation and fibrous obliteration of intrahepatic bile ductules due to an unknown (primary) stimulus. Etiology / pathogenesis : PBC is believed to be due to an autoimmune Q etiology as it is often associated with other autoimmune disorders Q such as I . CREST Q :Calcinosis, Raynaud's, Esophageal dysmotility, Sclorodactyly Talenglectasia SICCA SYNDROME Autoimmune thyroiditis Q Renal tubular acidosis Antimitochondrial Antibody (IgG) is positive Clinical feature : Most patients are asymptomatic Q Pruritis is commonest / earliest symptom Q Jaundice Melanosis: gradual darkening of exposed areas of skin Q Deficiency of fat soluble vitamins due to malabsorption Q Vit D deficiency : bone pain - osteomalacia Q Vit K deficiency : bleeding -- bruising (2 Vit A deficiency : Night blindness Q Xanthelisman & xanthomasQ due to protracted elcvaliar of serum lipids. Lab Findings : T1' Serum alkaline phosphatase Q (2-5 fold) Positive antimitochondrial antibody :Q Sensitive and specific Hyperlipidemia Q