The following questions were answered by:

Jenny Heathcote, MD, FRCP, FRCP(C)

• Toronto Western Hospital
• 399 Bathurst St. 6B Fell #154
• Toronto ON M5T 2S8

Question 1

Is there interaction with Urso and Calcium Citrate? If so, why? Best time to take Urso and Calcium.

Answer 1

There is no known interaction of Ca Co3 with UDCA

Question 2

Is there any pbc connection to osteoarthritis?

Answer 2

No, only with rheumatoid arthritis

Question 3

Is skin that gradually develops a mottled rash with colors of brownish, tan, orange, red and purple a symptom of pbc? I understand some people get a "tanned" appearance but mine couldn't really be described as tanned.

Answer 3

The skin pigmentation that may occur in some individuals with PBC is a grayish, dark brown. If the person itches a great deal there may be a somewht motttled appearance.

Question 4

I've read articles Effexor is harmful to the liver and should not be taken. Is this true or has it been proven safe for PBC disease? Are there other SSRI less harmful to the liver?

Answer 4

All SSRR can be used in those with liver disease but some may cause a liver problem but individuals with liver disease are not more at risk.

Question 5

Can portal hypertension show up on an ultrasound (blood flowing the wrong

way) one time and not show up on another ultrasound? Would this indicate

that portal hypertension can come and go?

Answer 5

Portal hypertension does not "come and go" but the U/S is VERY operator dependent so the reports may vary considerably!

Question 6

I have recently read in research abstracts about several women who had PBC (confirmed by biopsy) that also unfortunately developed breast cancer. As part of their treatment protocol they were placed on Tamoxifen. It is reported that their LFT's normalized for the 5 years of Tamoxifen therapy but again became elevated as soon as Tamoxifen therapy stopped. I have also heard about fibrolytic therapy being used in the management of specific types of cirrhosis. Your thoughts???

Answer 6

There is no increased risk of breast cancer in women with PBC. But if an individual with PBC gets breast cancer and is treated with Tamoxifen it has been noticed that the liver blood tests may improve, the mechanism whereby this occurs is not proven but speculated. Fibrolytic therapies are in the early phases of clinical trials for all forms of liver fibrosis /cirrhosis but there are currently no fibrolytic therapies that are licensed

I hope these answers help

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