Effectiveness of Extracorporeal Adsorption of Bile Acids with LDL Apheresis in a Case of Symptomatic Primary Biliary Cirrhosis

概要

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A 64-year-old woman was admitted to our clinic after complaints of pruritus and jaundice. Further examination after admission resulted in a diagnosis of advanced primary biliary cirrhosis (PBC) with high levels of serum bilirubin, bile acids and cholesterol. During the first two years, ursodeoxycholic acid and cholestyramine prevented elevation of the serum bilirubin level and worsening of pruritus. After five consecutive years, however, these medicines became ineffective. Therefore, plasmapheresis, which was plasma adsorption therapy using a parallel-connected activated charcoal column (DHP-1^<[○!R]>) and dex-tran sulfate column (LIPOSORBER<[○!R]>), was scheduled to remove the bilirubin, bile acids and cholesterol. This therapeutic modality could be performed with less disadvantage to patient's condition and smaller risk of infection by hepatitis viruses as compared to plasma exchange, and contributed to the clinical improve-ment of pruritus and hypercholesteremia. It was concluded that plasmapheresis might be an effective thera-peutic modality for advanced PBC when liver transplantation cannot be performed.
日本アフェレシス学会の論文
1997-10-31