Desafíos diagnósticos y terapéuticos en colangitis biliar primaria: un caso con pancitopenia y comorbilidades complejas

Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease characterized by the destruction of intrahepatic bile ducts, leading to cholestasis, progressive inflammation, and, in advanced stages, cirrhosis. This report describes a 60-year-old woman with a history of PBC, type 2 diabetes mellitus, and hyperlipidemia, presenting with scleral jaundice, pancytopenia, and splenomegaly. Diagnostic findings included elevated antimitochondrial antibodies (AMA) and antinuclear antibodies (ANA), pancytopenia secondary to hypersplenism, and splenomegaly confirmed via ultrasound. Treatment with ursodeoxycholic acid stabilized cholestasis, while pancytopenia remains under hematological monitoring. This case highlights the importance of a multidisciplinary approach to managing the metabolic, hematological, and hepatic complications of PBC, emphasizing the role of early diagnosis based on immunological markers and comprehensive management to prevent progression to liver failure. Patient education and continuous follow-up are critical to improving outcomes.