Hyperlipidemia in the Setting of Primary Biliary Cholangitis: A Case Report and Review of Management Strategies

Primary biliary cholangitis (PBC) is a chronic and progressive cholestatic autoimmune liver disease. Its characteristic is the destruction of intrahepatic bile ducts with portal inflammation and scarring. In the setting of cholestasis, there is a reduction in bile acid production and, consequently, decreased intestinal absorption of cholesterol. The result is the endogenous synthesis of cholesterol in the liver and the secretion of very low-density lipoprotein. Mixed hyperlipidemia can be challenging to manage, and the association with increased cardiovascular events remains unclear.