Horsmans Y, Piret A, Brenard R, Rahier J, Geubel A P
Department of Hepato-Gastroenterology, St Luc University Hospital (Catholic University of Louvain), Brussels, Belgium.
J Hepatol. 1994 Aug;21(2):194-8. doi: 10.1016/s0168-8278(05)80394-0.
The evolution from a characteristic picture of autoimmune chronic hepatitis type I to primary biliary cirrhosis is reported in a middle-aged woman. The initial diagnosis of autoimmune chronic liver disease was based on clinical, bio-serological and histological grounds. It was further confirmed by complete remission following immunosuppressive treatment and prompt relapses at the time of therapy withdrawal. After 7 years, the characteristics of liver disease were altered with increased biochemical cholestasis and serum IgM concentrations, positivation of previously negative anti-M2 antimitochondrial antibodies and the appearance of a typical histological picture of stage I primary biliary cirrhosis. We believe that this is the first reported case in which autoimmune chronic hepatitis highly responsive to immunosuppressive therapy has been followed by the development of a characteristic picture of primary biliary cirrhosis.
一名中年女性从I型自身免疫性慢性肝炎的典型症状发展为原发性胆汁性肝硬化的病例被报道。自身免疫性慢性肝病的初步诊断基于临床、生物血清学和组织学依据。免疫抑制治疗后完全缓解以及停药时迅速复发进一步证实了该诊断。7年后，肝病特征发生改变，生化胆汁淤积和血清IgM浓度升高，先前阴性的抗M2抗线粒体抗体转为阳性，并出现了I期原发性胆汁性肝硬化的典型组织学表现。我们认为这是首例有报道的病例，即对免疫抑制治疗高度敏感的自身免疫性慢性肝炎之后发展为原发性胆汁性肝硬化的典型症状。
