Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study

Kumaravelu Balasubramaniam, Patricia M. Grambsch, Russell H. Wiesner, Keith Lindor, E. Rolland Dickson

Research output: Contribution to journalArticle

98 Citations (Scopus)

Abstract

Data from 73 asymptomatic patients with primary biliary cirrhosis were analyzed to determine clinical course and long-term survival. Of these, 44 entered a d-penicillamine treatment trial; 29 qualified but chose not to participate. Median follow-up was 7.6 yr (range, 2.8-12.2 yr). Liver biopsy at the initial visit showed advanced disease (fibrosis, cirrhosis) in 61% of the patients. During prospective clinical followup, which was available for 37 of the 44 study patients, one or more symptoms of liver disease developed in 33 (89%); esophageal varices were found in 15 (41%), and histologic progression to cirrhosis was found in 20 (67%) of the 30 precirrhotic patients. Significant (p < 0.01) biochemical progression was reflected by a decrease in mean serum albumin concentrations and an increase in mean serum bilirubin levels in 32 patients followed for 4-6 yr. Survival data were available for all 73 patients; 17 died (11 secondary to liver failure), and 1 underwent liver transplantation. These patients had a 4-fold increase in mortality rate (p < 0.001) compared with the U.S. population matched for age, race, and sex.

Original languageEnglish (US)
Pages (from-to)1567-1571
Number of pages5
JournalGastroenterology
Volume98
Issue number6
StatePublished - 1990
Externally publishedYes

Fingerprint

Biliary Liver Cirrhosis
Prospective Studies
Survival
Fibrosis
Penicillamine
Esophageal and Gastric Varices
Liver Failure
Bilirubin
Serum Albumin
Liver Transplantation
Liver Diseases
Biopsy
Mortality
Liver
Serum
Population

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Balasubramaniam, K., Grambsch, P. M., Wiesner, R. H., Lindor, K., & Dickson, E. R. (1990). Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study. Gastroenterology, 98(6), 1567-1571.

Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study. / Balasubramaniam, Kumaravelu; Grambsch, Patricia M.; Wiesner, Russell H.; Lindor, Keith; Dickson, E. Rolland.

In: Gastroenterology, Vol. 98, No. 6, 1990, p. 1567-1571.

Research output: Contribution to journalArticle

Balasubramaniam, K, Grambsch, PM, Wiesner, RH, Lindor, K & Dickson, ER 1990, 'Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study', Gastroenterology, vol. 98, no. 6, pp. 1567-1571.
Balasubramaniam K, Grambsch PM, Wiesner RH, Lindor K, Dickson ER. Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study. Gastroenterology. 1990;98(6):1567-1571.
Balasubramaniam, Kumaravelu ; Grambsch, Patricia M. ; Wiesner, Russell H. ; Lindor, Keith ; Dickson, E. Rolland. / Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study. In: Gastroenterology. 1990 ; Vol. 98, No. 6. pp. 1567-1571.
@article{ea31b12c4eb74490b4023848ed415efd,
title = "Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study",
abstract = "Data from 73 asymptomatic patients with primary biliary cirrhosis were analyzed to determine clinical course and long-term survival. Of these, 44 entered a d-penicillamine treatment trial; 29 qualified but chose not to participate. Median follow-up was 7.6 yr (range, 2.8-12.2 yr). Liver biopsy at the initial visit showed advanced disease (fibrosis, cirrhosis) in 61{\%} of the patients. During prospective clinical followup, which was available for 37 of the 44 study patients, one or more symptoms of liver disease developed in 33 (89{\%}); esophageal varices were found in 15 (41{\%}), and histologic progression to cirrhosis was found in 20 (67{\%}) of the 30 precirrhotic patients. Significant (p < 0.01) biochemical progression was reflected by a decrease in mean serum albumin concentrations and an increase in mean serum bilirubin levels in 32 patients followed for 4-6 yr. Survival data were available for all 73 patients; 17 died (11 secondary to liver failure), and 1 underwent liver transplantation. These patients had a 4-fold increase in mortality rate (p < 0.001) compared with the U.S. population matched for age, race, and sex.",
author = "Kumaravelu Balasubramaniam and Grambsch, {Patricia M.} and Wiesner, {Russell H.} and Keith Lindor and Dickson, {E. Rolland}",
year = "1990",
language = "English (US)",
volume = "98",
pages = "1567--1571",
journal = "Gastroenterology",
issn = "0016-5085",
publisher = "W.B. Saunders Ltd",
number = "6",

}

TY - JOUR

T1 - Diminished survival in asymptomatic primary biliary cirrhosis. A prospective study

AU - Balasubramaniam, Kumaravelu

AU - Grambsch, Patricia M.

AU - Wiesner, Russell H.

AU - Lindor, Keith

AU - Dickson, E. Rolland

PY - 1990

Y1 - 1990

N2 - Data from 73 asymptomatic patients with primary biliary cirrhosis were analyzed to determine clinical course and long-term survival. Of these, 44 entered a d-penicillamine treatment trial; 29 qualified but chose not to participate. Median follow-up was 7.6 yr (range, 2.8-12.2 yr). Liver biopsy at the initial visit showed advanced disease (fibrosis, cirrhosis) in 61% of the patients. During prospective clinical followup, which was available for 37 of the 44 study patients, one or more symptoms of liver disease developed in 33 (89%); esophageal varices were found in 15 (41%), and histologic progression to cirrhosis was found in 20 (67%) of the 30 precirrhotic patients. Significant (p < 0.01) biochemical progression was reflected by a decrease in mean serum albumin concentrations and an increase in mean serum bilirubin levels in 32 patients followed for 4-6 yr. Survival data were available for all 73 patients; 17 died (11 secondary to liver failure), and 1 underwent liver transplantation. These patients had a 4-fold increase in mortality rate (p < 0.001) compared with the U.S. population matched for age, race, and sex.

AB - Data from 73 asymptomatic patients with primary biliary cirrhosis were analyzed to determine clinical course and long-term survival. Of these, 44 entered a d-penicillamine treatment trial; 29 qualified but chose not to participate. Median follow-up was 7.6 yr (range, 2.8-12.2 yr). Liver biopsy at the initial visit showed advanced disease (fibrosis, cirrhosis) in 61% of the patients. During prospective clinical followup, which was available for 37 of the 44 study patients, one or more symptoms of liver disease developed in 33 (89%); esophageal varices were found in 15 (41%), and histologic progression to cirrhosis was found in 20 (67%) of the 30 precirrhotic patients. Significant (p < 0.01) biochemical progression was reflected by a decrease in mean serum albumin concentrations and an increase in mean serum bilirubin levels in 32 patients followed for 4-6 yr. Survival data were available for all 73 patients; 17 died (11 secondary to liver failure), and 1 underwent liver transplantation. These patients had a 4-fold increase in mortality rate (p < 0.001) compared with the U.S. population matched for age, race, and sex.

UR - http://www.scopus.com/inward/record.url?scp=0025220745&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025220745&partnerID=8YFLogxK

M3 - Article

C2 - 2338193

AN - SCOPUS:0025220745

VL - 98

SP - 1567

EP - 1571

JO - Gastroenterology

JF - Gastroenterology

SN - 0016-5085

IS - 6

ER -