[Prognostic significance of antimitochondrial antibody profiles A-D in primary biliary cirrhosis].

Sera from 550 patients with primary biliary cirrhosis were tested by ELISA and the complement-fixation test (CFT) for the antimitochondrial antibodies (AMA) anti-M2, anti-M4, anti-M8 and anti-M9. Four profiles were defined and correlated with morphological and biochemical criteria - A: only anti-M9 positive by ELISA; B: anti-M9 and (or) anti-M2 positive by ELISA; C: anti-M2, anti-M4 and (or) anti-M8 positive by ELISA; D: anti-M2, anti-M4 and (or) anti-M8 positive by ELISA; D: anti-M2, anti-M4 and (or) anti-M8 positive by ELISA and CFT. Liver biopsies were obtained in 385 patients. Analysis of histological stage at the time of first serological testing revealed PBC stages I/II or only nonspecific lesions in all group A patients and in 90% of group B patients, while 49% of patients in group C and 59% of those in group D had stage III/IV or had histological features of chronic active hepatitis or "mixed form". Levels of alkaline phosphatase and GPT were significantly higher in groups C/D than groups A/B patients (P less than 0.05), and bilirubin and IgG levels were more frequently elevated in the former groups of patients (P less than 0.05). It is concluded that classification of PBC into AMA profiles may help in identifying patients at high or low risk of progression of the disease.