Dörner T, Held C, Trebeljahr G, Lukowsky A, Yamamoto K, Hiepe F
Dept. of Medicine III, Medical School (Charité), Humboldt University of Berlin, Germany.
Scand J Gastroenterol. 1994 Jul;29(7):655-60. doi: 10.3109/00365529409092488.
Patients with primary biliary cirrhosis (PBC) may have coincidental sicca syndrome (SS). The frequencies of SS and the occurrence of the Sjögren's-associated anti-Ro and -La antibodies in PBC patients have been reported at widely varying prevalences. This study investigated whether distinctive serologic characteristics are associated with SS in PBC.
Forty PBC patients and thirty patients with other types of liver cirrhosis were tested for SS and associated autoantibodies (ANA, AMA 2, anti-Ro, anti-La, anti-U1RNP-A, -C, -68 kD, and rheumatoid factors).
Fourteen PBC patients (35%) complained of sicca symptoms, of whom 10 (25%) had a positive Schirmer-I test, and 7 (17.5%) had serologic characteristics similar to those of Sjögren's syndrome. Anti-52-kD Ro antibodies were positive in seven PBC/SS cases (p < 0.025). There was no anti-Ro positive PBC patient without SS. Three patients with PBC/SS with anti-52-kD Ro and anti-smooth-muscle antibodies developed lung fibrosis. No patient in the other cirrhosis group had SS or its characteristic autoantibody findings.
It was suggested that PBC and SS are frequently associated. Anti-52-kD Ro antibodies seem to be a characteristic serologic finding for SS in PBC, suggesting their pathogenic role in autoimmune sialadenitis.
原发性胆汁性肝硬化(PBC)患者可能并发干燥综合征(SS)。PBC患者中SS的发生率以及与干燥综合征相关的抗Ro和抗La抗体的出现率报道差异很大。本研究调查了PBC中与SS相关的独特血清学特征。
对40例PBC患者和30例其他类型肝硬化患者进行了SS及相关自身抗体(抗核抗体、抗线粒体抗体2型、抗Ro、抗La、抗U1核糖核蛋白A、C、68kD以及类风湿因子)检测。
14例PBC患者(35%)主诉有干燥症状,其中10例(25%)施默尔I试验阳性,7例(17.5%)血清学特征与干燥综合征相似。7例PBC/SS患者抗52-kD Ro抗体阳性(p<0.025)。无SS的PBC患者中抗Ro抗体均为阴性。3例PBC/SS患者同时有抗52-kD Ro和抗平滑肌抗体,并发肺纤维化。其他肝硬化组患者均无SS或其特征性自身抗体表现。
提示PBC与SS常相关。抗52-kD Ro抗体似乎是PBC中SS的特征性血清学表现,提示其在自身免疫性涎腺炎中的致病作用。