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Abstract
Twenty patients without symptoms of hepatobiliary disease were diagnosed as having
asymptomatic primary biliary cirrhosis. In every patient liver histology was diagnostic
of, suggestive of, or compatible with the diagnosis. Eighteen had a positive serum
mitochondrial antibody, 18 had raised serum immunoglobulin M, and 17 had markedly
raised serum alkaline phosphatase values. A mean of 4.5 years after diagnosis, 10
of the patients had not developed hepatobiliary symtoms; 4 of these 10 patients have
survived 6 to 10 years. Ten patients developed symptoms after a mean of 2.2 years
from initial diagnosis; 7 are still alive but 3 have died of liver failure. The development
of symptoms could not be predicted by either serum biochemical tests or hepatic histology.
It is concluded that the diagnosis of asymptomatic primary biliary cirrhosis is compatible
with 10 or more asymptomatic years.