A 48-year-old woman presents with progressive pruritus and fatigue for 3 months. Vital signs: BP 118/76, HR 88, RR 16, Temp 98.6°F, SpO2 98% on room air. Laboratory studies reveal alkaline phosphatase 312 U/L, total cholesterol 284 mg/dL, and serum anti-mitochondrial antibodies positive. Liver biopsy demonstrates granulomatous inflammation of intrahepatic bile ducts. She denies recent alcohol use. Which of the following best describes the underlying pathologic lesion?

  1. A)Fibrosing inflammation of intrahepatic and extrahepatic bile ducts associated with ulcerative colitis
  2. B)Massive hepatocyte necrosis after acetaminophen overdose
  3. C)Autoimmune destruction of small intrahepatic bile ductsGABARITO
  4. D)Copper deposition due to ATP7B mutation
  5. E)Obstruction of the common bile duct by a pancreatic head mass

Explicação

Primary biliary cholangitis is an autoimmune cholestatic disease characterized by destruction of small intrahepatic bile ducts, leading to pruritus, elevated alkaline phosphatase, hypercholesterolemia, and anti-mitochondrial antibodies. It occurs classically i... Ver explicação completa e trilha adaptativa →

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