What additional clinical features can accompany primary biliary cholangitis?

Primary biliary cholangitis (PBC) is an autoimmune liver disease characterized by the progressive destruction of the small and medium-sized bile ducts within the liver. This destruction leads to cholestasis and eventually cirrhosis if left untreated. Patients with PBC can exhibit a number of clinical features due to the underlying disease process and its systemic effects.

One notable additional feature that can accompany primary biliary cholangitis is the presence of xanthomas. These are cholesterol-rich lesions that can appear on the skin, particularly around the eyes, elbows, and tendons. The development of xanthomas in patients with PBC is related to lipid metabolism abnormalities that arise from impaired bile acid synthesis and poor lipid digestion and absorption due to cholestasis.

While gallbladder distension might suggest a pathology involving gallstones or obstruction, it is not a feature directly associated with PBC, which primarily affects the intrahepatic bile ducts. Jaundice can occur in PBC, especially in later stages of the disease, but noting it as an isolated feature may not capture the broader clinical spectrum. Bone fractures can occur in patients with liver disease due to metabolic bone disease, but they are not a defining feature of PBC itself and would generally not