A case of primary biliary cirrhosis showing clinical and histological remission.

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We report a case of disappearance of non-suppurative cholangitis and decrease of antimitochondrial antibody levels observed by three histological examinations of the liver. The patient was a forty-year-old female. She had no particular past history. She was admitted with common-cold like symptoms and jaundice. The finding of a positive AMA (320×) suggested the possibility of primary biliary cirrhosis (PBC), but by the clinical course and histological findings she was diagnosed as having acute cholestastic hepatitis and discharged. After 3 month's observation, elevation of hepatobiliary enzymes was observed again, and liver biopsy was done. Histologically, it showed typical PBC. Six months later, colloid reaction and hepatobiliary enzymes changed to normal. Two years and three months after the first examination, PBC was not seen histologically. There was no clinical symptoms and all laboratory studies were normal except for an IgM level of 267mg/dl and a positive AMA (80×). It was thought that there was a possibility of it being a case of asymptomatic PBC complicated by acute hepatitis, and as a result due to some type of immunological mechanism.
社団法人日本肝臓学会の論文