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An older study of asymptomatic patients has suggested that the presence of hepatomegaly, advanced histological stage or the presence of associated autoimmune disorders is strongly predictive of the subsequent development of PBC-related symptoms (pruritus, jaundice, ascites or variceal bleeding) [182,188], while a more recent study has not been able to identify any prognostic variables that would distinguish patients who would become symptomatic from those who would remain asymptomatic [181]