Liver Stiffness, Patient-Reported Fatigue, and Pruritus in Primary Biliary Cholangitis and Primary Sclerosing Cholangitis: A Cross-Sectional Study

@article{abadiron2026liver,
  title = {{Liver Stiffness, Patient-Reported Fatigue, and Pruritus in Primary Biliary Cholangitis and Primary Sclerosing Cholangitis: A Cross-Sectional Study}},
  author = {Victoria Abadi-Ron and Daniela Terrazas-Duque and Ana Marenco-Flores and Natalia Rojas-Amaris and Fernando Munguia and Romelia Barba Bernal and Daniela Goyes and John Esli Medina-Morales and Leandro Sierra and Behnam Saberi and Vilas Patwardhan and Alan Bonder},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = oct,
  doi = {10.3390/jcm15207928},
  url = {https://www.mdpi.com/2077-0383/15/20/7928},
  note = {CC BY 4.0},
}

TY  - JOUR
TI  - Liver Stiffness, Patient-Reported Fatigue, and Pruritus in Primary Biliary Cholangitis and Primary Sclerosing Cholangitis: A Cross-Sectional Study
AU  - Victoria Abadi-Ron
AU  - Daniela Terrazas-Duque
AU  - Ana Marenco-Flores
AU  - Natalia Rojas-Amaris
AU  - Fernando Munguia
AU  - Romelia Barba Bernal
AU  - Daniela Goyes
AU  - John Esli Medina-Morales
AU  - Leandro Sierra
AU  - Behnam Saberi
AU  - Vilas Patwardhan
AU  - Alan Bonder
PY  - 2026
DA  - 2026/10/01
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15207928
UR  - https://www.mdpi.com/2077-0383/15/20/7928
AB  - Background: Fatigue and pruritus are common and disabling in primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), but their severity is not reliably explained by standard biochemical markers. Whether liver stiffness measured by transient elastography reflects these symptoms remains unclear. This study examined associations between liver stiffness and fatigue and pruritus in PBC and PSC, and between routine biochemical measures and symptom burden. Methods: This cross-sectional analysis included 107 patients (56 PBC, 51 PSC) from a prospective autoimmune liver disease registry. Fatigue was assessed with the CLDQ-29 fatigue domain and pruritus with the CLDQ-29 pruritus item or the itch visual analog scale. Multivariable linear and ordered logistic regression examined associations between liver stiffness and fatigue and pruritus, adjusted for disease type, age, and sex. Spearman correlations assessed associations between liver stiffness and clinical and laboratory variables, with Benjamini–Hochberg correction. Receiver operating characteristic analysis assessed discrimination. Results: Patients with PBC were older (59 vs. 51 years; p < 0.001) and more often female (96.4% vs. 56.9%; p < 0.001) than those with PSC. Liver stiffness (6.0 vs. 6.8 kPa; p = 0.101), fatigue scores, pruritus scores, and itch VAS were similar between groups. Liver stiffness was not associated with fatigue (β = 0.005; p = 0.835) or pruritus (OR = 0.97; p = 0.190) after adjustment; only age was associated with fatigue (β = 0.021; p = 0.020). Among laboratory measures, only ALP remained correlated with liver stiffness after correction (ρ = 0.309; adjusted p = 0.027). In PSC alone, higher liver stiffness was associated with worse pruritus (ρ = −0.37; p = 0.009), a finding not seen in PBC. Liver stiffness alone showed limited discrimination for fatigue (AUC 0.46) and pruritus (AUC 0.56); a model with disease type, age, and sex improved discrimination modestly for fatigue (AUC 0.60) but not for pruritus (AUC 0.57). Conclusions: Liver stiffness was not associated with fatigue or pruritus in the overall cohort of patients with PBC and PSC, and a possible association with pruritus in PSC needs confirmation. Patient-reported outcomes should be assessed alongside biochemical and elastographic measures, and how they relate to objective measures of disease remains an open question.
SN  - 2077-0383
ER  -