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PBC and PSC

PBC: Management

osteopenia and osteoporosis

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lose bone mass at twice rate of controls

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risk of osteoporosis 8 times matched controls

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50% of post transplant PBC patients suffer fractures

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treatment: exercise, calcium and vitamin D (25,000-100,000 IU/week)

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bisphosphonates need further study

fat soluble vitamins

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monitor vitamins D, A and E

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trial of vitamin K for prolonged prothrombin time

pruritus

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cholestyramine 4-16 gm/day divided before and after breakfast

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rifampin or oral naltrexone can be useful in non-responders

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can require transplantation

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