Skill Checkup: A 44-Year-Old Woman With Treated Primary Biliary Cholangitis Is Not Responding To Therapy

Richard Kalman, MD


February 15, 2023

The Skill Checkup series provides a quick, case-style interactive quiz highlighting key guidelines- and evidence-based information to inform clinical practice.

A 44-year-old woman from the United Kingdom with primary biliary cholangitis (PBC) presents for a follow-up. The patient is employed part-time as a barista in a café. She was diagnosed with PBC slightly over 1 year ago and she began receiving therapy with ursodeoxycholic acid (UDCA) shortly thereafter. Except for some moderate fatigue, the patient does not report any new or bothersome symptoms. She is not taking any medications other than UDCA. No abnormalities are noted upon physical examination. Pertinent laboratory study results include alkaline phosphatase (ALP) of 247 IU/L (> 1.67 x ULN) and bilirubin of 2.0 mg/dL. She does not have cirrhosis on imaging. The patient is 1.65 m (5 ft 5 in) tall and weighs 70.31 kg (155 lb).


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