Department of Rheumatology, Jining No.1 People's Hospital, Jining, China.
Medicine (Baltimore). 2023 Oct 13;102(41):e35655. doi: 10.1097/MD.0000000000035655.
A chronic autoimmune liver disease known as primary biliary cholangitis (PBC) that selectively destructs small intrahepatic biliary epithelial cells and may result in biliary cirrhosis and eventually liver transplantation or death. PBC is associated with various other extrahepatic autoimmune diseases; however, the combination of PBC with ankylosing spondylitis has been rarely reported in the literature. Here, we reported a case of PBC with ankylosing spondylitis to improve our understanding of such coexistence and provide new ideas for the treatment of such patients.
A 54-year-old man was presented to the Department of Rheumatology because of an abnormal liver function test for 7 years, chest and back pain for 1 year, and low back pain for 2 months.
Primary biliary cholangitis, ankylosing spondylitis, and old pulmonary tuberculosis.
The patient refused to use nonsteroidal anti-inflammatory drugs, conventional synthetic disease-modifying antirheumatic drugs, and biologic disease-modifying antirheumatic drugs; thus, he was treated with methylenediphosphonate (99Tc-MDP) and ursodeoxycholic acid (UDCA).
The patient achieved remission with UDCA and 99Tc-MDP therapy.
In the treatment of PBC combined with other disorders, the characteristics of different diseases should be considered. The patient reported herein was treated with 99Tc-MDP and UDCA, and his condition improved; thus, we consider 99Tc-MDP to be an effective treatment. Furthermore, in line with the current understanding of the pathogenesis of PBC and ankylosing spondylitis, we hypothesize that interleukin-17 inhibitor is an effective treatment for such patients.
一种称为原发性胆汁性胆管炎（PBC）的慢性自身免疫性肝病，选择性地破坏小的肝内胆管上皮细胞，可能导致胆汁性肝硬化，最终导致肝移植或死亡。PBC 与多种其他肝外自身免疫性疾病有关；然而，文献中很少报道 PBC 与强直性脊柱炎同时发生。在这里，我们报告了一例 PBC 合并强直性脊柱炎的病例，以提高我们对这种共存的认识，并为治疗此类患者提供新思路。
一名 54 岁男性因肝功能异常 7 年、胸背痛 1 年、腰痛 2 个月就诊于风湿科。
原发性胆汁性胆管炎、强直性脊柱炎和陈旧性肺结核。
患者拒绝使用非甾体抗炎药、传统合成改善病情抗风湿药和生物改善病情抗风湿药；因此，他接受了二膦酸盐（99Tc-MDP）和熊去氧胆酸（UDCA）治疗。
患者经 UDCA 和 99Tc-MDP 治疗后缓解。
在治疗 PBC 合并其他疾病时，应考虑不同疾病的特点。本文报告的患者接受了 99Tc-MDP 和 UDCA 治疗，病情得到改善；因此，我们认为 99Tc-MDP 是一种有效的治疗方法。此外，根据对 PBC 和强直性脊柱炎发病机制的现有认识，我们假设白细胞介素-17 抑制剂是此类患者的有效治疗方法。
