Skopouli F N, Barbatis C, Moutsopoulos H M
Department of Internal Medicine, Medical School, University of Ioannina, Greece.
Br J Rheumatol. 1994 Aug;33(8):745-8. doi: 10.1093/rheumatology/33.8.745.
Three hundred patients with primary Sjögren's syndrome (pSS) were investigated for liver involvement using clinical, biochemical, immunological and histological data. Seven per cent of patients showed evidence of liver disease either subclinical (2%) or asymptomatic (5%) with elevated liver enzymes. In 6.6% of patients antimitochondrial antibodies (AMA) were detected by immunofluorescence and 27% of pSS patients showed antibodies to pyruvate dehydrogenase (a-PDH) using ELISA. AMA-positive patients were further investigated with transcutaneous liver biopsy. Ninety-two per cent of patients with AMA showed liver involvement with features of chronic cholangitis similar to stage I primary biliary cirrhosis. It is concluded that liver involvement in pSS patients is rare and subclinical with histological features predominantly of stage I primary biliary cirrhosis. AMA is the most sensitive indicator of underlying liver pathology in pSS patients.
对300例原发性干燥综合征（pSS）患者进行了研究，利用临床、生化、免疫和组织学数据评估肝脏受累情况。7%的患者有肝脏疾病证据，其中2%为亚临床型，5%无症状但肝酶升高。6.6%的患者通过免疫荧光检测到抗线粒体抗体（AMA），27%的pSS患者使用酶联免疫吸附测定法检测到丙酮酸脱氢酶抗体（a-PDH）。AMA阳性患者进一步接受经皮肝活检。92%的AMA阳性患者有肝脏受累，具有类似于I期原发性胆汁性肝硬化的慢性胆管炎特征。研究得出结论，pSS患者肝脏受累情况罕见且多为亚临床型，组织学特征主要为I期原发性胆汁性肝硬化。AMA是pSS患者潜在肝脏病变最敏感的指标。
