Lindgren S, Manthorpe R, Eriksson S
Gastroenterology and Hepatology Division, Department of Medicine, Malmö General Hospital, Lund University, Sweden.
J Hepatol. 1994 Mar;20(3):354-8. doi: 10.1016/s0168-8278(94)80007-3.
Forty-five patients with primary Sjögren's syndrome were studied for evidence of autoimmune liver disease. Twenty-nine patients had normal liver function tests, normal IgM and a normal test for antimitochondrial antibodies and smooth muscle antibodies. Among the remaining 16 patients, abnormal liver function tests were found in 12 (27% of all patients); eight of these patients had biochemical cholestasis. Elevated plasma IgM (> 2 g/l) was observed in nine patients, three with normal liver function tests, while antimitochondrial antibodies were positive in six patients, one with normal liver function tests, and smooth muscle antibodies were found in three. Based on these findings and percutaneous liver biopsy, a diagnosis of primary biliary cirrhosis was established in four patients and autoimmune chronic active hepatitis in two. The present study showed that abnormal liver function tests in patients with primary Sjögren's syndrome are frequent and may indicate associated autoimmune liver disease. These data further emphasize the systemic nature of autoimmune disorders.
对45例原发性干燥综合征患者进行了自身免疫性肝病证据的研究。29例患者肝功能检查正常、IgM正常且抗线粒体抗体和平滑肌抗体检测正常。在其余16例患者中，12例（占所有患者的27%）肝功能检查异常；其中8例患者有生化性胆汁淤积。9例患者血浆IgM升高（>2g/L），3例肝功能检查正常，6例抗线粒体抗体阳性，1例肝功能检查正常，3例发现平滑肌抗体。基于这些发现及经皮肝活检，4例患者诊断为原发性胆汁性肝硬化，2例诊断为自身免疫性慢性活动性肝炎。本研究表明，原发性干燥综合征患者肝功能检查异常很常见，可能提示存在相关的自身免疫性肝病。这些数据进一步强调了自身免疫性疾病的系统性本质。
