<prompt> Cause of pruritus in primary biliary cirrhosis?TGR 4Glucagon like peptideVanilloid receptorGastrin releasing peptide  <response>: Primary biliary cirrhosis- Characterized by chronic inflammation and fibrous obliteration of intrahepatic bile ductules. Associated with autoimmune disorders-CREST syndrome, Sicca syndrome, Autoimmune thyroiditis, Type-1 Diabetes mellitus and IgA deficiency. Mostly seen in females Age is 35-60 yrs CF-Pruritis, jaundice, steatorrhoea, xanthelasma, hepatomegaly, splenomegaly, ecchymosis, osteomalacia. Cause of pruritis is due to vanilloid receptor Associated with cholesterol stones not pigment stones due to reduced bile acid synthesis . Lab findings: Serum 5 nucleotidase activity Gamma-glutamyl transpeptidase activity Serum bilirubin levels Serum lipid levels ALP Confirmation test- Liver biopsy Florid duct lesion granuloma Treatment of choice is liver transplantation. Primary biliary cirrhosisnow called as Primary Biliary Cholangitis 