Kakhktsyan Tigran, Aleksanyan Mesrop, Acob Talar, Hakobyan Knkush
Internal Medicine, Capital Health Regional Medical Center, Trenton, USA.
Cureus. 2024 Jul 4;16(7):e63812. doi: 10.7759/cureus.63812. eCollection 2024 Jul.
Multiple sclerosis (MS) is a chronic inflammatory disease that causes demyelination in the brain and spinal cord, leading to significant neurological disability in young adults. Patients with MS are predisposed to other autoimmune disorders, though the co-occurrence of MS and primary biliary cholangitis (PBC) is rare. PBC is an autoimmune liver disease that affects bile ducts, leading to cholestasis and liver cirrhosis, predominantly in women aged over 40 years. We report the case of an 81-year-old woman with a history of MS and hypertension, bedridden for 10 years, who was admitted with a severe sacral ulcer and bacteremia. During hospitalization, she developed persistent itching, and elevated liver enzymes were detected. Imaging ruled out cholecystitis but revealed a large gallstone and hepatomegaly. Elevated M2 antimitochondrial antibodies confirmed PBC. The patient was treated with ursodeoxycholic acid, leading to symptom improvement. This case highlights the necessity for a thorough evaluation of autoimmune comorbidities in patients with MS and suggests a potential genetic and environmental link between MS and PBC. Further research is needed to explore this association and improve treatment strategies.
多发性硬化症（MS）是一种慢性炎症性疾病，可导致脑和脊髓脱髓鞘，致使年轻成年人出现严重的神经功能障碍。MS患者易患其他自身免疫性疾病，不过MS与原发性胆汁性胆管炎（PBC）同时出现的情况较为罕见。PBC是一种自身免疫性肝病，主要影响胆管，导致胆汁淤积和肝硬化，多见于40岁以上的女性。我们报告了一例81岁女性患者，有MS和高血压病史，卧床10年，因严重的骶部溃疡和菌血症入院。住院期间，她出现持续瘙痒，检测发现肝酶升高。影像学检查排除了胆囊炎，但发现有一个大的胆结石和肝肿大。M2抗线粒体抗体升高确诊为PBC。该患者接受了熊去氧胆酸治疗，症状得到改善。本病例凸显了对MS患者的自身免疫性合并症进行全面评估的必要性，并提示MS与PBC之间可能存在遗传和环境方面的联系。需要进一步研究来探索这种关联并改进治疗策略。
