The condition of prolonged obstructive jaundice with patent bile ducts was first described in 1851 by Addison and Gull of Guy's Hospital, London. The term primary biliary cirrhosis (PBC) was defined in 1950 by Ahrens and colleagues of the Rockefeller Institute, New York. The condition was considered rare but this changed in 1965 with the discovery of a definitive diagnostic serum mitochondrial antibody test and the recognition that a raised serum alkaline phosphatase value, often discovered incidentally, could be a diagnostic pointer. If the diagnosis is made earlier, the end stages are rarely reached as death is replaced by liver transplantation. On November 6th 1997, in Chicago, an International Faculty discussed in depth the clinical features, pathogenesis and treatment of PBC, no longer considered a rare disease. The course of PBC is long, but some 18 years after the discovery of a positive mitochondrial antibody test in a symptom free patient with normal serum biochemistry, 83% will have developed abnormal tests and 76% will be symptomatic. Identification of those who will progress rapidly is difficult. The serum antimitochondrial profile may be useful but this is a very specialist technique. Mathematical prognostic models are useful in therapeutic trials and in the selection and timing of patients for liver transplantation but have limited value in individual patients. An increasing serum bilirubin level remains the most important indicator of rapid progression. Its value however can be negated by the use of ursodeoxycholic acid which has a bilirubin-lowering effect."

Since the publication of the first edition, there have been advances in both the diagnosis and the management of many of the cholestatic liver diseases. Cholestatic Liver Disease, Second Edition thoroughly updates the topics previously addressed, such as primary biliary cirrhosis, primary sclerosing cholangitis, and cholestatic variants of drug hepatotoxicity and viral disease. New treatments, such as the development of the farnesoid X receptor agonists for the treatment of PBC, are highlighted. Current guidelines and areas of uncertainty are also covered. Additionally, new chapters have been added to reflect the changing landscape of cholestatic liver disease. Cholestatic Liver Disease, Second Edition is a concise yet comprehensive summary of the current status of the field and is of value to clinicians and researchers interested in patients with cholestatic liver disease provide that will help to guide patient management and stimulate investigative efforts.

Get the authoritative, up-to-date information you need on liver disease from the 7th Edition of the most trusted reference worldwide. Covering both basic science and recent clinical developments, this revised edition by Drs. Arun J. Sanyal, Thomas D. Boyer, Norah A. Terrault, and Keith D. Lindor, provides an in-depth, comprehensive look at the pathophysiology, diagnostic, and treatment information related to the liver. More than 1,100 figures and tables, many new and in full color, highlight completely updated content throughout. Expert, international authorship and comprehensive, easy-to-access information makes this edition the gold standard in the field of hepatology. Expert ConsultT eBook version included with purchase. This enhanced eBook experience allows you to search all of the text, figures, videos, and references from the book on a variety of devices. Includes new information on the rapid changes in treatment paradigms for acute liver failure, the latest treatments for primary biliary cholangitis, full coverage of the gut microbiome and its role in liver disease, the newest developments in drug-induced liver injury, and changes in hepatitis C virus treatment and hot-button concerns about access to care. New summary boxes at the end of each chapter and a newly streamlined table of contents make it easier to find and understand the information you're looking for. Hundreds of brand-new illustrations clearly present key aspects of liver disease.

Since the publication of the first edition, there have been advances in both the diagnosis and the management of many of the cholestatic liver diseases. Cholestatic Liver Disease, Second Edition thoroughly updates the topics previously addressed, such as primary biliary cirrhosis, primary sclerosing cholangitis and cholestatic variants of drug hepatotoxicity and viral disease. New treatments, such as the development of the farnesoid X receptor agonists for the treatment of PBC, are highlighted. Current guidelines and areas of uncertainty are also covered. Additionally, new chapters have been added to reflect the changing landscape of cholestatic liver disease. Cholestatic Liver Disease, Second Edition is a concise yet comprehensive summary of the current status of the field and is of value to clinicians and researchers interested in patients with cholestatic liver disease provide that will help to guide patient management and stimulate investigative efforts.

The condition of prolonged obstructive jaundice with patent bile ducts was first described in 1851 by Addison and Gull of Guy's Hospital, London. The term primary biliary cirrhosis (PBC) was defined in 1950 by Ahrens and colleagues of the Rockefeller Institute, New York. The condition was considered rare but this changed in 1965 with the discovery of a definitive diagnostic serum mitochondrial antibody test and the recognition that a raised serum alkaline phosphatase value, often discovered incidentally, could be a diagnostic pointer. If the diagnosis is made earlier, the end stages are rarely reached as death is replaced by liver transplantation. On November 6th 1997, in Chicago, an International Faculty discussed in depth the clinical features, pathogenesis and treatment of PBC, no longer considered a rare disease. The course of PBC is long, but some 18 years after the discovery of a positive mitochondrial antibody test in a symptom free patient with normal serum biochemistry, 83% will have developed abnormal tests and 76% will be symptomatic. Identification of those who will progress rapidly is difficult. The serum antimitochondrial profile may be useful but this is a very specialist technique. Mathematical prognostic models are useful in therapeutic trials and in the selection and timing of patients for liver transplantation but have limited value in individual patients. An increasing serum bilirubin level remains the most important indicator of rapid progression. Its value however can be negated by the use of ursodeoxycholic acid which has a bilirubin-lowering effect."