抗核膜抗体陽性を示した原発性胆汁性肝硬変の1例

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A 58-year-old man, who was habitual drinker and had been pointed out liver dysfunction since about six years ago, was admitted to our hospital with pruritus of three years duration. On admission, icterus was not noticed, though a xanthoma was found around his right eyelid, and the liver was palpable 1cm below the right costal margin. Laboratory data showed the increase of serum biliary enzymes and IgM. Anti-mitochondria antibody showed negative, but anti-nuclear envelope (210kD protein) antibody revealed positive. Laparoscopy showed dark reddish patchy markings scattered on the liver surface, and liver biopsy sample showed marked inflammatory cell infiltration in the portal areas and the degeneration of interlobular bile ducts. Therefore, the diagnosis was made as primary biliary cirrhosis. After oral administration of ursodeoxycholic acid, serum biliary enzyme and IgM levels were gradually improved. Antinuclear envelope antibody has been recently reported to be specific in primary biliary cirrhosis. The test of this antibody is thought to be useful, especially in the anti-mitochondria antibody negative case like the present case.
社団法人日本肝臓学会の論文