| Title |
Treatment options for primary biliary cirrhosis and primary sclerosing cholangitis
|
|---|---|
| Published in |
Current Treatment Options in Gastroenterology, April 2003
|
| DOI | 10.1007/s11938-003-0010-0 |
| Pubmed ID | |
| Authors |
Cynthia Levy, Keith D. Lindor |
| Abstract |
Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) are chronic cholestatic liver diseases that affect 0.5 to 40 per 100,000 and 1 to 6 per 100,000 Americans, respectively. Prompt recognition and management of the clinical manifestations of these diseases is essential for the patients' well-being and ultimate outcome. Ursodeoxycholic acid (UDCA), 13 to 15 mg/kg per day, is the standard therapy for PBC and should be offered to every patient. It has been shown to slow progression of the disease and prevent the need for liver transplantation, which is the last recourse for patients with end-stage disease. However, there is no effective therapy for PSC yet. Patients are managed symptomatically, with surgical or endoscopic interventions as needed in cases of significant biliary obstruction. Complications of chronic cholestasis are seen in both PBC and PSC, with pruritus and fatigue being the most common complaints. The first choice for the treatment of pruritus is still cholestyramine, starting at 4 g/d. The pathogenesis of fatigue is poorly understood in this population; unrecognized hypothyroidism should be excluded. The use of antidepressants is currently under evaluation, but there is no specific therapy for fatigue as of yet. For prevention of severe osteoporosis, we recommend supplementation with 800 IU vitamin D and 1500 mg calcium/d. In patients with PBC and established osteoporosis, the use of alendronate and vitamin K appears to cause an increase in bone mineral density. Further studies are necessary before either of these drugs is routinely recommended. Finally, fat-soluble vitamin deficiencies are noted with more advanced disease. We recommend that serum levels be checked in high-risk patients, and that vitamins are replaced as appropriate with water-soluble supplements. However, other causes of malabsorption must be ruled out, including pancreatic insufficiency and celiac sprue. |
Mendeley readers
The data shown below were compiled from readership statistics for 17 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 17 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Bachelor | 5 | 29% |
| Student > Master | 2 | 12% |
| Student > Doctoral Student | 2 | 12% |
| Other | 1 | 6% |
| Student > Ph. D. Student | 1 | 6% |
| Other | 1 | 6% |
| Unknown | 5 | 29% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 6 | 35% |
| Psychology | 2 | 12% |
| Mathematics | 1 | 6% |
| Philosophy | 1 | 6% |
| Biochemistry, Genetics and Molecular Biology | 1 | 6% |
| Other | 1 | 6% |
| Unknown | 5 | 29% |
Attention Score in Context
This research output has an Altmetric Attention Score of 3. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 13 July 2014.
All research outputs
#8,513,013
of 25,382,250 outputs
Outputs from Current Treatment Options in Gastroenterology
#93
of 287 outputs
Outputs of similar age
#20,686
of 62,492 outputs
Outputs of similar age from Current Treatment Options in Gastroenterology
#1
of 3 outputs
Altmetric has tracked 25,382,250 research outputs across all sources so far. This one is in the 43rd percentile – i.e., 43% of other outputs scored the same or lower than it.
So far Altmetric has tracked 287 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.2. This one is in the 47th percentile – i.e., 47% of its peers scored the same or lower than it.
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