Case Report

Primary Biliary Cirrhosis with a normal Alkaline Phosphatase: a case report

Joshua M Brostoff¹, Sukaina Rashid² and Daniel McCrea²

¹  34 Fitzjohns Avenue, London , NW3 5NB, UK

²  Central Middlesex Hospital, London, NW10 7NS, UK

Cases Journal 2008, 1:33doi:10.1186/1757-1626-1-33

Published:	14 July 2008

Abstract

A 78 year-old lady presented with abdominal swelling and fatigue. She was anaemic with mild hypoalbuminaemia, and had a normal alkaline phosphatase. Computed tomography showed hepatosplenomegaly and mild ascites. Anti mitochondrial antibodies were strongly positive, as were anti nuclear antibodies, and the gamma glutamyl-transferase was shown to be elevated. A diagnosis of primary biliary cirrhosis was made. A brief discussion of treatment of primary biliary cirrhosis follows. The case is notable for the fact that primary biliary cirrhosis can manifest clinically without an elevation in alkaline phosphatase – normally the hallmark of the disease.