Features of the course of primary biliary cholangitis in women at different age periods: Literature review

The review examines the issues of epidemiology, etiological factors, pathogenetic mechanisms, clinical and diagnostic approaches and principles of treatment of primary biliary cholangitis in women. The prevalence of primary biliary cholangitis is very variable and ranges from 0.9 to 58.2 per 100,000 people. Women account for up to 90% of all cases, so an important aspect is to characterize the course of this disease depending on the age period. Epidemiological data suggest that primary biliary cholangitis predominantly affects postmenopausal women and is more often diagnosed in this group at later stages. The development and progression of this pathology is associated with a number of genetic, autoimmune, and environmental factors. More than half of the patients have another autoimmune disease along with primary biliary cholangitis. During the reproductive age, patients often have a long latency period without pronounced clinical symptoms, an increased risk of anovulatory cycles and menstrual irregularities. Pregnancy in women with primary biliary cholangitis is associated with an increased risk of gestational hypertension, preeclampsia, and premature birth. After menopause, the clinical picture of this disease often becomes more pronounced, and the likelihood of developing cirrhosis and liver failure increases. There are gender differences in the prevalence, risk factors, and clinical outcomes of primary biliary cholangitis. The incidence reaches its peak among postmenopausal women. In pregnant women, this pathology is relatively rare, but it has significant clinical consequences for both the mother and the fetus.

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