Liu Yang, Xu Jianbin, Chen Yimei, Wang Lingling, Chen Wen, Shen Jing
Department of Endocrinology, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China.
Department of Pathology, the Eighth Medical Center of PLA General Hospital, Beijing 100091, China.
JCEM Case Rep. 2025 Apr 10;3(5):luaf030. doi: 10.1210/jcemcr/luaf030. eCollection 2025 May.
Primary biliary cholangitis (PBC) is a chronic cholestatic liver disease characterized by interlobular bile duct inflammation, which causes fibrosis and cirrhosis. Few studies have explored the association of hypoglycemia with PBC. In this case, a 76-year-old Chinese man diagnosed with PBC developed recurrent comatose episodes. The patient had severe hypoglycemia and slight abnormalities in liver function tests. In addition, the patient had positive results in antimitochondrial antibody, anti-mitochondrial antibody-subtype 2, centromeric protein B antibody, and antisoluble acidic nuclear protein 100 antibody levels, which led to the diagnosis of PBC. The patient also experienced fasting hypoglycemic coma, requiring thorough evaluation to identify potential causes. This case suggests that liver-derived hypoglycemia associated with PBC may be more common than autoimmune-related hypoglycemia in this context.
原发性胆汁性胆管炎（PBC）是一种慢性胆汁淤积性肝病，其特征为小叶间胆管炎症，可导致纤维化和肝硬化。很少有研究探讨低血糖与PBC之间的关联。在此病例中，一名76岁被诊断为PBC的中国男性出现反复发作的昏迷。该患者有严重低血糖，肝功能检查有轻微异常。此外，该患者抗线粒体抗体、抗线粒体抗体2型、着丝粒蛋白B抗体及抗可溶性酸性核蛋白100抗体水平呈阳性，这导致了PBC的诊断。该患者还经历了空腹低血糖昏迷，需要进行全面评估以确定潜在病因。此病例表明，在这种情况下，与PBC相关的肝源性低血糖可能比自身免疫相关低血糖更为常见。
