Guo Liping, Zhou Lu, Zhang Na, Deng Baoru, Wang Bangmao
Department of Gastroenterology and Hepatology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Rheumatology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Gastroenterol Res Pract. 2017;2017:2376231. doi: 10.1155/2017/2376231. Epub 2017 Jan 16.
Autoimmune liver diseases (AILDs) often coexist with other extrahepatic autoimmune diseases (EHAIDs). The spectrum of EHAIDs in patients with AILDs is similar, whereas the incidence is different. Notably, autoimmune thyroid disease and Sjogren's syndrome are the most common EHAIDs. Associated extrahepatic diseases may predate the appearance of AILDs or coincide with their onset. More frequently, they may appear during the course and even occur years after the diagnosis of AILDs. Importantly, associated EHAIDs may influence the natural course and prognosis of AILDs. To date, a definite pathophysiological pathway which contributes to the coexistence of AILDs and EHAIDs is still lacking. The current view of autoimmunity clustering involves a common susceptibility genetic background which applies to related pathologies. Herein, we review the current published researches regarding EHAIDs in patients with AILDs, particularly in relation to their clinical impact and pathophysiology. In managing patients with AILDs, gastroenterologists should be aware of the possibly associated EHAIDs to ensure a prompt diagnosis and better outcome.
自身免疫性肝病(AILD)常与其他肝外自身免疫性疾病(EHAID)共存。AILD患者中EHAID的谱型相似,但发病率不同。值得注意的是,自身免疫性甲状腺疾病和干燥综合征是最常见的EHAID。相关的肝外疾病可能在AILD出现之前就已存在,或与AILD的发病同时出现。更常见的是,它们可能在病程中出现,甚至在AILD诊断多年后发生。重要的是,相关的EHAID可能影响AILD的自然病程和预后。迄今为止,仍缺乏导致AILD和EHAID共存的确切病理生理途径。目前关于自身免疫聚集的观点涉及适用于相关病理的共同易感性遗传背景。在此,我们综述了目前已发表的关于AILD患者中EHAID的研究,特别是关于它们的临床影响和病理生理学。在管理AILD患者时,胃肠病学家应意识到可能相关的EHAID,以确保及时诊断并获得更好的结果。