Ep 113: A 62-Year-Old with Pruritis

Harrison's PodClass: Internal Medicine Cases and Board Prep

Learn more about this in Chapter 355: Cirrhosis and Its Complications
In this episode of Harrison's Podclass, Dr. Cathy Handy and Dr. Charlie Wiener tackle the case of a 62-year-old woman presenting with pruritus and a constellation of symptoms including fatigue, weight loss, and intermittent nausea. The discussion delves into the diagnostic process, highlighting key clinical findings such as jaundice, spider angiomata, and a nodular liver.

Dr. Handy and Dr. Wiener explore the implications of these findings, focusing on the differential diagnosis for cirrhosis and the potential underlying causes. The episode emphasizes the significance of antimitochondrial antibodies (AMA) in diagnosing primary biliary cholangitis (PBC), a condition characterized by chronic liver inflammation and bile duct destruction.

Listeners will gain insights into the histopathology of PBC, typical laboratory findings, and the treatment options available, including the role of Ursodeoxycholic acid and liver transplantation. The episode concludes with a brief review of alternative diagnostic tests and their relevance in the broader context of liver disease.

Tune in for a comprehensive discussion on diagnosing and managing liver conditions in an older adult, with practical insights for clinicians dealing with similar cases.

Harrison's Principles of Internal Medicine, 22nd Edition