ABORTION
It seems possible that diagnosis of PBC in Chinese persons may have been missed by lack of awareness or a preponderance of other disease processes, and it is possible that a more vigorous pursuit of hepatosplenomegaly or elevated serum alkaline phosphatase levels in the Singapore population might reveal further instances of the disease.
Abstract
origin is difficult to explain . However . it may be related to the aetiology of the disease wh ich is at present. unknown. although immune com plexes have recenlly been implicated.' Such complexes can be detected in seruin of patients with PBC. resulting in activation of complement by the alternate pathway and producing tissue damage. There could . possibly. be some genetic factors in Chinese which result in a difference in handl ing antigen or antibody with protect ion from tissue damage. However . it seems possible that diagnosis of PBC in Chinese persons may have been missed by lack of awareness or a preponderance of other disease processes. Persons w ith PBC may be asymptomat ic. or they may present w ith associated diseases. for example. rheumatoid arthritis. pernicious anaemia. telang iectasia or other autoimmune diseases ." Female Chinese patients are reluctant to seek medical advice. in our experience. for tolerable symptoms such as jaundice or pruritus. II is possible that a more vigorous pursuit of hepatosplenomegaly or elevated serum alkaline phosphatase levels in the Singapore population might reveal further instances of PBC. K. P. LIM. K. T. Ho. H. M. GWEE. H. L. CHAN. University Department of Medicine (II) . Singapore General Hospital. Singapore .