A 57-year-old woman with Hashimoto thyroiditis presents with progressive fatigue and intense generalized pruritus for 3 months. Vital signs: BP 128/82 mmHg, HR 76/min, RR 14/min, temp 37.2°C. Laboratory studies reveal alkaline phosphatase 320 U/L, positive antimitochondrial antibodies, and normal aminotransferases. Abdominal ultrasound shows no intrahepatic or extrahepatic bile duct dilation. She takes levothyroxine daily. Which diagnosis best explains these findings?
- A)Gilbert syndrome
- B)Primary sclerosing cholangitis
- C)Acute viral hepatitis
- D)Primary biliary cholangitisGABARITO
- E)Autoimmune hepatitis
Explicação
Primary biliary cholangitis is autoimmune destruction of small intrahepatic bile ducts classically affecting middle aged women with antimitochondrial antibodies. Ver explicação completa e trilha adaptativa →