Histological follow-up of a case of asymptomatic primary biliary cirrhosis in 70 year-old man.

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The follow-up of clinical course and histology were performed during a period of more than three years in a case of asymptomatic primary biliary cirrhosis (PBC) with chronic rheumatoid arthritis in 70 year old man. The first histological findings showed those of CNSDC, compatible with stage I of PBC (Scheuer). Laboratory data and immunological tests were as follows; serum total bilirubin 0.7mg/dl, Al-p 14.0 K.A.U., IgM 2110mg/dl, anti-mitochondrial antibody (AMA) 1:1280, and anti-nuclear antibody 1:20. The second wedged liver biopsy three years later showed the features of stage I of PBC, in which mononuclear cell infiltration in portal areas was less prominent that of the first biopsy. Laboratory data and immunological data were improved. The patients received D-penicillamine 200mg/day for nine months for the purpose of the treatment of rheumatoid arthritis and PBC.