Progression of primary biliary cirrhosis after proctocolectomy for ulcerative colitis

We report a case of progression of primary biliary cirrhosis (PBC) after pr octocolectomy for ulcerative colitis. A 43-year-old woman underwent a total proctocolectomy after being diagnosed with ulcerative colitis. In the cour se of the preoperative investigation, liver function test results were with in the normal range. Four months after the proctocolectomy, the patient sho wed a high level of alkaline phosphatase (2398IU/l) and a positive anti-mit ochondrial antibody titer (>1:160). There were no associated symptoms. A li ver biopsy demonstrated expansion of all portal areas by infiltrates of lym phocytes and histiocytes. These appearances indicated chronic biliary disea se and were compatible with PBC. The association of PBC and ulcerative coli tis is rare. However, a review of the recent literature suggests that PBC a nd ulcerative colitis may be associated; this combination should be kept in mind.