A case with serological and histological evidence for an overlapping of primary biliary cirrhosis and lupoid hepatitis.

概要

論文の詳細を見る
This 51 year-old female was evaluated, because of episodes of Raynaud's phenomenon, Sjögren syndrome and general malaise. There was neither skin itching nor jaundice.<BR>The ERCP showed a well visualized gallbladder and a patent extrahepatic as well as intrahepatic biliary tract. Serum GOT, GPT and ALP were mildly elevated. Serum cholesterol was normal. Antimitochondrial antibody (AMA) was positive, and anti-smooth muscle antibody (ASMA), anti-nuclear antibody (ANA), anti-DNA antibody and LE cell test were all positive. The wedge liver biopsy specimen showed mixed features characteristic of both PBC and CAH. Subsequently, severe general malaise, loss of appetite and mild jaundice developed. SGOT and SGPT elevated up to 580 KU and 770 KU, respectively. The ASMA, ANA and anti-DNA antibody were stronly positive. The LE cell test remained positive.<BR>The diagnosis of an overlapping syndrome of PBC and lupoid hepatitis was made. The patient responded well to steroid therapy with prominent improvement of symptoms and liver function test. PBC specific antigen (anti-M2) was positive, but mixed-form antigen (anti-M4) negative.
社団法人日本肝臓学会の論文