Therapeutic effect of estradiol benzoate on primary biliary cirrhosis -A case report

A case of asynptomatic primary biliary cirrhosis (a-PBC) succesfully treated with estradiol benzoate (EB) was reported. This 35-year-old female was admitted to the Kitasato University Hospital complaining of general fatigue. The liver function tests showed a mild elevation of bilirubin, accompained by an elevation of transaminase, alkaline phosphatase (ALP) and γ-glutamyltranspeptitase (γ-GTP) levels. Serum immnoglobulines of all three major classes were elevated, but elevation of IgM was most conspicuous with the degree of 395mg/100ml. Also demonstrated was positive test for anti-mitochondrial antibody. Biopsy of the liver disclosed PBC (stage 2-3 of Scheuer) with piecemeal necrosis and portal=portal bridging. The patient received 1mg EB every one or two weeks. Estradiol treatment was followed by return toward normal values of ALP and γ-GTP. Histology obtained at 16 and 33 months of treatment showed disappearance of piecemeal necrosis and portal=portal bridging, respectively. No remarkable side effect was observed in the course of treatment. The observation suggests that EB has a salutary effect on PBC.