Journal of Shandong University (Health Sciences) ›› 2022, Vol. 60 ›› Issue (8): 98-102.doi: 10.6040/j.issn.1671-7554.0.2022.0699

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Primary biliary cholangitis with bone pain as the main manifestation: a case report

CHEN Shihong, JIANG Dongqing, ZHUANG Xianghua, LI Xiaobo, PAN Zhe, SUN Aili, LOU Nengjun, WANG Dianhui, DU Jiaojiao, SONG Yuwen   

  1. Department of Endocrinology, The Second Hospital of Shandong University, Jinan 250033, Shandong, China
  • Published:2022-07-27

Abstract: Objective Primary biliary cholangitis(PBC)is a rare autoimmune liver disease, which is one of the rare causes of secondary osteoporosis. In this paper, we will report a case of PBC with bone pain as the main manifestation, in order to arouse clinicians attention to this disease. Methods A case of elderly women with bone pain as the main manifestation was enrolled, and the results of laboratory examinations, bone mineral density and X-ray image of bones were evaluated. The clinical characteristics of PBC with osteoporosis were summarized by reviewing the literature. Results The patient was a 61-year-old female with pain in both hips and knees for more than 1 year. Dual-energy X-ray absorptiometry indicated osteoporosis. The patient showed no symptoms of biliary tract obstruction such as fatigue, skin itching, or yellow staining. However, laboratory examinations showed elevated biliary tract enzyme, including gamma-glutamyl transferase(GGT)and alkaline phosphatase(ALP). Her anti-mitochondrial antibody type Ⅱ(AMA-M2)was positive. These results indicated that her osteoporosis was probably caused by PBC. Conclusion The clinical manifestations of PBC are insidious. PBC should be considered in patients with osteoporosis, especially when the bile duct enzymes are elevated and AMA-M2 is positive.

Key words: Primary biliary cholangitis, Secondary osteoporosis, Bone pain, Bisphosphonates

CLC Number: 

  • R575.7
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