Primary biliary cirrhosis classification: Difference between revisions

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* 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>
* 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>
* 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>


{| class="wikitable"
{| class="wikitable"
! Classification of Primary biliary cirrhosis on the basis of histology
! colspan="3" | Classification of Primary biliary cirrhosis on the basis of histology
|-
|-
!Ludwig classification
| rowspan="2" |Stage
! Ludwig classification
! Scheuer's classification
|-
|-
|Stage
| colspan="2" | Histologic appearance
|Histologic  
|-
|-
|Stage 0
|Stage 0
|Normal liver
|Normal liver
|florid duct lesion or chronic non-suppurative destructive cholangitis
|-
|-
|Stage 1
|Stage 1
|Stage 1 is characterized by portal inflammation
|Stage 1 is characterized by portal inflammation
|proliferation of the small bile ductules
|-
|-
|Stage 2
|Stage 2
|Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss
|Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss
|fibrosis or scarring
|-
|-
|Stage 3
|Stage 3
|There is presence of fibrous septa linking adjacent portal tracts
|There is presence of fibrous septa linking adjacent portal tracts
|cirrhosis
|-
|-
|Stage 4
|Stage 4
|Stage 4 is characterized by cirrhosis
|Stage 4 is characterized by cirrhosis
|-
!Scheuer's classification
|-
|Stage 1
|florid duct lesion or chronic non-suppurative destructive cholangitis
|-
|Stage 2
| proliferation of the small bile ductules
|-
|Stage 3
| fibrosis or scarring
|-
|Stage 4
| cirrhosis
|}
|}


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==References==
==References==

Revision as of 20:28, 5 February 2018

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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]

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.[1]

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 Ludwig classification Scheuer's classification
Histologic appearance
Stage 0 Normal liver florid duct lesion or chronic non-suppurative destructive cholangitis
Stage 1 Stage 1 is characterized by portal inflammation proliferation of the small bile ductules
Stage 2 Extension of inflammation beyond portal tracts into surrounding parenchyma with or without ductal loss fibrosis or scarring
Stage 3 There is presence of fibrous septa linking adjacent portal tracts cirrhosis
Stage 4 Stage 4 is characterized by cirrhosis


References

  1. 1.0 1.1 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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