{"id":8753,"date":"2015-05-28T15:07:52","date_gmt":"2015-05-28T13:07:52","guid":{"rendered":"https:\/\/dev.93-93-113-41.plesk.page\/?page_id=8753"},"modified":"2024-06-01T12:20:22","modified_gmt":"2024-06-01T10:20:22","slug":"cirrosi-biliar-primaria","status":"publish","type":"page","link":"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/cirrosi-biliar-primaria\/","title":{"rendered":"Cirrosi Biliar Prim\u00e0ria"},"content":{"rendered":"

Qu\u00e8 \u00e9s la Cirrosi Biliar Prim\u00e0ria?<\/h2>\n

La Cirrosi Biliar Prim\u00e0ria (CBP) \u00e9s una malaltia cr\u00f2nica d’origen probablement autoimmune en la qual hi ha una desaparici\u00f3 de les vies biliars de mitj\u00e0 i petit calibre. Afecta sobretot a les dones entre els 40 i els 60 anys. Malgrat el seu nom, no tots els pacients que tenen aquesta malaltia s\u00f3n cirr\u00f2tics.<\/p>\n

Quins s\u00edmptomes t\u00e9?<\/h2>\n

Els s\u00edmptomes s\u00f3n molt inespec\u00edfics. Fins a un quart dels pacients el diagn\u00f2stic es realitza com una troballa casual. El s\u00edmptoma predominant \u00e9s el cansament, seguit de la picor generalitzat. Alguns pacients presenten mol\u00e8sties a la part superior dreta de l’abdomen.<\/p>\n

Quins signes t\u00e9?<\/h2>\n

En l’exploraci\u00f3 f\u00edsica es pot detectar un augment de la mida normal del fetge, aix\u00ed com un augment de la pigmentaci\u00f3 de la pell. La coloraci\u00f3 groguenca de la pell (icter\u00edcia) pot estar present tamb\u00e9. En fases avan\u00e7ades de la malaltia es poden trobar petits dip\u00f2sits de greix a les parpelles anomenats xantelasmes.<\/p>\n

Quan hi ha una malaltia hep\u00e0tica avan\u00e7ada poden trobar signes secundaris a l’augment de la pressi\u00f3 dels vasos venosos abdominals (hipertensi\u00f3 portal) com per exemple augment del per\u00edmetre abdominal per acumulaci\u00f3 de l\u00edquid (ascites) o augment de la mida de la melsa (esplenomeg\u00e0lia).<\/p>\n

Com es diagnostica?<\/h2>\n

Per realitzar el diagn\u00f2stic cal fer una anal\u00edtica completa en la qual s’observi una elevaci\u00f3 dels enzims que indiquen dany en les vies biliars. La bilirubina pot estar elevada o no. Tamb\u00e9 \u00e9s freq\u00fcent trobar elevaci\u00f3 de la immunoglobulina M (IgM). El m\u00e9s espec\u00edfic per diagnosticar aquesta malaltia \u00e9s la positivitat per als anticossos antimitocondrials (AMA), que es troba fins en un 95% dels pacients. Hi pot haver alteraci\u00f3 dels enzims hep\u00e0tics o alteracions pr\u00f2pies de la hipertensi\u00f3 portal i la cirrosi en el cas que estiguin instaurades.<\/p>\n

\u00c9s important descartar una obstrucci\u00f3 de la via biliar mitjan\u00e7ant una prova d’imatge com ara la Ecografia, la tomografia axial computeritzada (TAC) o una resson\u00e0ncia magn\u00e8tica (RM). En ocasions es pot trobar inflamaci\u00f3 dels ganglis. Les proves d’imatge tamb\u00e9 s\u00f3n \u00fatils per estudiar signes de malaltia hep\u00e0tica avan\u00e7ada (cirrosi).<\/p>\n

La fibrosi es pot mesurar a trav\u00e9s de t\u00e8cniques de elastograf\u00eda de transici\u00f3 hep\u00e0tica (FibroScan CAP\u00ae<\/a>).<\/p>\n

Quin pron\u00f2stic t\u00e9?<\/h2>\n

Un pacient diagnosticat de Cirrosi biliar prim\u00e0ria sense tractament, probablement progressar\u00e0 en el temps cap a una malaltia hep\u00e0tica avan\u00e7ada amb totes les complicacions derivades d’aquesta. No obstant aix\u00f2, amb un tractament adequat, es pot aconseguir frenar la malaltia de forma satisfact\u00f2ria. Un dels s\u00edmptomes que pot originar m\u00e9s mol\u00e8sties \u00e9s la picor de pell (pru\u00efja), per al qual hi ha m\u00faltiples alternatives terap\u00e8utiques.<\/p>\n

Com es tracta?<\/h2>\n

El principal tractament \u00e9s l’\u00c0cid ursodesoxic\u00f2lic ja que aconsegueix frenar el curs de la malaltia.
\nExisteixen tractaments immunosupressors (com el Metotrexate) amb el qual es pot observar una millora de les an\u00e0lisis de laboratori aix\u00ed com de la histologia hep\u00e0tica.
\nPer al tractament de la picor de pell (pru\u00efja) ha m\u00faltiples opcions que van des de l’\u00fas d’antihistam\u00ednics fins el recanvi plasm\u00e0tic en casos greus i refractaris.<\/p>\n","protected":false},"excerpt":{"rendered":"

Qu\u00e8 \u00e9s la Cirrosi Biliar Prim\u00e0ria? La Cirrosi Biliar Prim\u00e0ria (CBP) \u00e9s una malaltia cr\u00f2nica d’origen probablement autoimmune en la qual hi ha una desaparici\u00f3 de les vies biliars de mitj\u00e0 i petit calibre. Afecta […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":0,"parent":7391,"menu_order":8,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"class_list":["post-8753","page","type-page","status-publish"],"yoast_head":"\nCirrosi Biliar Prim\u00e0ria - Servidigest<\/title>\n<meta name=\"description\" content=\"La Cirrosi Biliar Prim\u00e0ria (CBP) \u00e9s una malaltia cr\u00f2nica d'origen probablement autoimmune en la qual hi ha una desaparici\u00f3 de les vies biliars de mitj\u00e0 i petit calibre. Afecta sobretot a les dones entre els 40 i els 60 anys. Malgrat el seu nom, no tots els pacients que tenen aquesta malaltia s\u00f3n cirr\u00f2tics.\" \/>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/dev.93-93-113-41.plesk.page\/ca\/serveis\/aparell-digestiu\/hepatologia\/cirrosi-biliar-primaria\/\" \/>\n<meta property=\"og:locale\" content=\"ca_ES\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Cirrosi Biliar Prim\u00e0ria - Servidigest\" \/>\n<meta property=\"og:description\" content=\"La Cirrosi Biliar Prim\u00e0ria (CBP) \u00e9s una malaltia cr\u00f2nica d'origen probablement autoimmune en la qual hi ha una desaparici\u00f3 de les vies biliars de mitj\u00e0 i petit calibre. Afecta sobretot a les dones entre els 40 i els 60 anys. 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