Primary biliary cirrhosis classification: Difference between revisions

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{{Primary biliary cirrhosis}}
{{Primary biliary cirrhosis}}
{{CMG}}; {{AE}}  
{{CMG}}; {{AE}} {{AA}} {{Anmol}}


==Overview==
==Overview==
There is no established system for the classification of Primary biliary cirrhosis. However, it can be classified into four stages depending on the histology of the disease.
There is no established system for the classification of primary biliary cirrhosis. However, it can be classified into four stages according to [[histological]] classification of Ludwig. It can also be classified into four stages according to the [[histological]] classification of P. Scheuer.


==Classification==
==Classification==
 
* There is no established system for the classification of primary biliary cirrhosis.
*There is no established system for the classification of primary biliary cirrhosis. However, it can be classified into four stages according to histological classification of Ludwig. According to Ludwig classification, all four stages may be present on a single liver biopsy.  
* However, it can be classified into four stages according to [[histological]] classification of Ludwig. According to Ludwig classification, all four stages may be present on a single [[liver biopsy]].<ref name="pmid19554543">{{cite journal| author=Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ et al.| title=Primary biliary cirrhosis. | journal=Hepatology | year= 2009 | volume= 50 | issue= 1 | pages= 291-308 | pmid=19554543 | doi=10.1002/hep.22906 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19554543  }} </ref><ref name="pmid150690">{{cite journal| author=Ludwig J, Dickson ER, McDonald GS| title=Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis). | journal=Virchows Arch A Pathol Anat Histol | year= 1978 | volume= 379 | issue= 2 | pages= 103-12 | pmid=150690 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=150690  }} </ref>
 
* It can also be classified into four stages according to the [[histological]] classification of P. Scheuer.<ref name="pmid6066569">{{cite journal| author=Scheuer P| title=Primary biliary cirrhosis. | journal=Proc R Soc Med | year= 1967 | volume= 60 | issue= 12 | pages= 1257-60 | pmid=6066569 | doi= | pmc=1901478 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=6066569  }}</ref>
===Stage 1===
<br>
Stage 1 is characterized by portal inflammation.
{|
 
! colspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + | Classification of Primary biliary cirrhosis on the basis of histology
===Stage 2===
|-
Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss.
! rowspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Stage
 
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + | Histologic appearance
===Stage 3===
|-
There is presence of fibrous septa linking adjacent portal tracts.
! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |Ludwig classification
 
! style="background:#7d7d7d; color: #FFFFFF;" align="center" + |Scheuer's classification
===Stage 4===
|-
Stage 4 is characterized by cirrhosis.
| style="background:#DCDCDC;" align="center" + |Stage 1
| style="background:#F5F5F5;" + |Portal inflammation
| style="background:#F5F5F5;" + |Florid duct lesion or chronic non-suppurative destructive cholangitis
|-
| style="background:#DCDCDC;" align="center" + |Stage 2
| style="background:#F5F5F5;" + |Extension of inflammation beyond portal tracts into surrounding [[parenchyma]] with or without ductal loss
| style="background:#F5F5F5;" + |Proliferation of the small bile ductules
|-
| style="background:#DCDCDC;" align="center" + |Stage 3
| style="background:#F5F5F5;" + |Presence of fibrous septa linking adjacent portal tracts
| style="background:#F5F5F5;" + |[[Fibrosis]] or [[scarring]]
|-
| style="background:#DCDCDC;" align="center" + |Stage 4
| style="background:#F5F5F5;" + |[[Cirrhosis]]
| style="background:#F5F5F5;" + |[[Cirrhosis]]
|}


==References==
==References==
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[[Category:Gastroenterology]]
[[Category:Hepatology]]
[[Category:Disease]]
[[Category:Rheumatology]]
[[Category:Medicine]]
[[Category:Up-To-Date]]

Latest revision as of 23:49, 29 July 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aysha Anwar, M.B.B.S[2] Anmol Pitliya, M.B.B.S. M.D.[3]

Overview

There is no established system for the classification of primary biliary cirrhosis. However, it can be classified into four stages according to histological classification of Ludwig. It can also be classified into four stages according to the histological classification of P. Scheuer.

Classification

  • There is no established system for the classification of primary biliary cirrhosis.
  • However, it can be classified into four stages according to histological classification of Ludwig. According to Ludwig classification, all four stages may be present on a single liver biopsy.[1][2]
  • It can also be classified into four stages according to the histological classification of P. Scheuer.[3]


Classification of Primary biliary cirrhosis on the basis of histology
Stage Histologic appearance
Ludwig classification Scheuer's classification
Stage 1 Portal inflammation Florid duct lesion or chronic non-suppurative destructive cholangitis
Stage 2 Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss Proliferation of the small bile ductules
Stage 3 Presence of fibrous septa linking adjacent portal tracts Fibrosis or scarring
Stage 4 Cirrhosis Cirrhosis

References

  1. Lindor KD, Gershwin ME, Poupon R, Kaplan M, Bergasa NV, Heathcote EJ; et al. (2009). "Primary biliary cirrhosis". Hepatology. 50 (1): 291–308. doi:10.1002/hep.22906. PMID 19554543.
  2. Ludwig J, Dickson ER, McDonald GS (1978). "Staging of chronic nonsuppurative destructive cholangitis (syndrome of primary biliary cirrhosis)". Virchows Arch A Pathol Anat Histol. 379 (2): 103–12. PMID 150690.
  3. Scheuer P (1967). "Primary biliary cirrhosis". Proc R Soc Med. 60 (12): 1257–60. PMC 1901478. PMID 6066569.

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