Abstract
A 55-year-old woman was admitted to our hospital in 1981 because of itching and liver dysfunction. Laboratory Batas had shown high level of serum ALP, γ-GTP, ALP, IgM and slight liver dysfunction. On the basis of clinical symptoms and laboratory data, although anti-mitochondrialantibody (AMA) was negative, we suspected primary biliary cirrhosis (PBC). Laparoscopic examination was performed and diagnosed as PBC stage II according to Scheuer's classification and following up thereafter for 8 years until present. In the clinical course, esophageal varices were revealed in 1985, and RC sign was appeared in 1987. Then, sclerotherapy for esophageal varices were performed several times. But no therapeutic effect was obtained and pancytopenia due to hypersplenism was advanced. Therefore resection of esophageal varices and splenectomy and wedge biopsy of the liver were performed in 1988. Histological examination revealed PBC stage III according to Scheuer's classification. In patient with PBC, esophageal varices may appear even though the liver morphology and function are not advanced to cirrhosis. We suggest upper GI endoscopy should be performed even in the patient of early stage of PBC to exclude the possibility of variceral bleeding.
