P-110 CHANGES IN THE CLINICAL PRESENTATION OF PRIMARY BILIARY CHOLANGITIS (PBC) OVER THE YEARS IN A UNIVERSITY CENTER IN ARGENTINA

Conflict of interest

No

Introduction and Objectives

The clinical presentation of primary biliary cholangitis (PBC) has changed globally over time. However, these data have not been sufficiently analyzed in our setting. Objective: To analyze changes in the clinical presentation of PBC over the last 40 years in a university center in Argentina.

Patients / Materials and Methods

A retrospective study including 596 patients, divided into four groups according to the year of diagnosis: <1990 (N=113), 1990-1999 (N=206), 2000-2009 (N=151), and >2009 (N=106). Variables analyzed included age at diagnosis, disease stage, clinical presentation (asymptomatic or symptomatic), biochemical stages (according to Rotterdam criteria), and histological stages.

Results and Discussion

The female-to-male ratio was 24:1 and remained stable over time. There was an increase in the mean age at diagnosis, from 54.3 years (±11.6) before 1990 to 57.2 years (±12.2) after 2009 (p=0.0185). The symptomatic clinical variant decreased from 73.7% to 50.0% (p<0.001), while early biochemical stage diagnosis increased from 18.0% to 77.4% (p<0.001) over the same period. Advanced histological stages (III-IV) decreased from 60.2% before 1990 to 20.8% after 2009 (p<0.001).

Conclusions

Over time, patients with PBC have shown a change in their clinical presentation, characterized by an older age at diagnosis, earlier biochemical and histological stages, and a predominance of asymptomatic clinical forms. These findings are consistent with global reports and may be attributable to better knowledge of the disease, greater availability and access to diagnostic tests, and possibly changes in environmental triggers over time.