علاج التشمع الصفراوي البدئي PBC

THanx TH

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ليش بنعطي استروجين ؟ ما وظائف الكبد مضطربة و استقلاب الاسترجين الكبدي بالحد الأدنى وبالتالي رح يكون الاستروجين مرتفع

Observations in a small number of patients suggest a benefit from estrogen therapy in postmenopausal women with PBC [10,18] . One study focused on 46 postmenopausal women with PBC who received estrogen replacement therapy and were compared to 46 age-matched controls with PBC who did not receive estrogen therapy [18] . Bone mineral density was adjusted for age and ethnic group. During an average of 4.8 years of follow-up, patients who received estrogen had a significantly lower rate of bone loss. Worsening cholestasis attributable to treatment was not observed.

There has been theoretical concern that the cholestatic effect of estrogens might increase the risk of breast cancer, which may already be elevated in PBC [19,20] . However, cholestasis does not worsen with estrogen therapy in PBC and may even improve [10,21,22] .

However, the indications for estrogen therapy have changed, given the results of the Women's Health Initiative which reported an increased risk of breast cancer and cardiovascular complications. We do not routinely recommend estrogen for the management of osteoporosis in postmenopausal women with PBC, but it may be a reasonable option for women who have undergone an early menopause