輸血後肝炎として経過中にIgMの漸増を契機に診断しえた男性のPBCの1例

概要

論文の詳細を見る
A 43-year-old man was admitted for the post-transfusional hepatitis in 1978. Liver needle biopsy was performed in 1980 and diagnosed as chronic active hepatitis. During the course of illnes, he complained no symptoms. Serum IgM elevated from 199mg/dl (1980) to 1161mg/dl (1988) during a period of about 8 years. Because of the extremely high level of serum IgM, primary biliary cirrhosis (PBC) was suspected. The laboratory data showed no elevation of serum bilirubin, alkaline phosphatase and γ-GTP but antimitochondrial antibody was always positive in 1988.<BR>Therefore, laparoscopic examination was perfomed and diagnosed as PBC stage I according to the Scheuer's classification in 1988. The first liver biopsy specimen were reexamined and there were the findings of PBC in addition to that of chronic hepatitis.<BR>The increase of serum IgM in the clinical course of PBC was observed in this case and it was suggested that pathological abnormality may preceede the biochemical abnormality such as elevation of IgM, alkaline phosphatase and γ-GTP in PBC.