This patients elevated alkaline phosphatase is consistent with cholestasis, the predominant manifestation of primary biliary cirrhosis. Patients with this disease also may present with pruritus. Primary biliary cirrhosis has a 9:1 female to male ratio, making it more likely than primary sclerosing cholangitis. The patient denies a history of alcohol use, and results of liver function tests are not consistent with that of alcoholic cirrhosis (also known as Laennecs cirrhosis) (eg, 2:1 ratio of aspartate aminotransferase/alanine aminotransferase). Nonalcoholic steatohepatitis is not likely to present with cholestasis.
- Primary biliary cirrhosis.
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Seminars in Medical Practice
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