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三例原发性胆汁性肝硬化合并支气管哮喘。

Three cases of primary biliary cirrhosis associated with bronchial asthma.

作者信息

Terasaki S, Nakanuma Y, Hoso M, Ogino H, Unoura M, Kobayashi K, Mizuno Y, Nakagawa H, Shimizu M, Kanai M

机构信息

Second Department of Pathology, Kanazawa University School of Medicine, Japan.

出版信息

J Gastroenterol. 1995 Oct;30(5):667-71. doi: 10.1007/BF02367796.

Abstract

The association of primary biliary cirrhosis (PBC) and bronchial asthma was observed in three patients. All of these patients were female (53, 54, and 41 years old, respectively), and were positive for antimitochondrial antibodies. The patients fulfilled the diagnostic criteria of both PBC and bronchial asthma. Bronchial asthma preceded PBC in two patients, and the reverse order was seen in the other. Patient the clinical symptoms were mainly due to the bronchial asthma. Two patients had asymptomatic PBC and the third patient complained of pruritus. The liver histology showed mild to moderate eosinophilic infiltration in addition to the ductal and hepatic parenchymal changes characteristic of PBC. A survey of 266 cases of PBC referred to us disclosed that, in 6 of these, the PBC was associated with bronchial asthma, while no association with bronchial asthma was the material of found in 166 patients with viral hepatitis in our liver biopsy files. The 3 present cases we experienced suggest that bronchial asthma may be included in the list of extrahepatic diseases associated with PBC. The significance of this association is unclear and may merit further study. Steroid therapy, which is known to cause adverse effects in PBC, was employed for bronchial asthma in these 3 patients. Another therapeutic approach will have to be considered in patients with bronchial asthma associated with PBC.

摘要

在三名患者中观察到原发性胆汁性肝硬化(PBC)与支气管哮喘之间的关联。所有这些患者均为女性(分别为53岁、54岁和41岁),抗线粒体抗体呈阳性。这些患者符合PBC和支气管哮喘的诊断标准。两名患者支气管哮喘先于PBC出现,另一名患者情况相反。患者的临床症状主要归因于支气管哮喘。两名患者患有无症状PBC,第三名患者主诉瘙痒。肝脏组织学检查除了显示PBC特有的胆管和肝实质改变外,还显示轻度至中度嗜酸性粒细胞浸润。对转诊至我们这里的266例PBC病例进行的一项调查显示,其中6例PBC与支气管哮喘相关,而在我们肝脏活检档案中的166例病毒性肝炎患者中未发现与支气管哮喘相关的病例。我们遇到的这3例现有病例表明,支气管哮喘可能被列入与PBC相关的肝外疾病清单中。这种关联的意义尚不清楚,可能值得进一步研究。已知在PBC中会产生不良反应的类固醇疗法被用于这3例支气管哮喘患者。对于与PBC相关的支气管哮喘患者,将必须考虑另一种治疗方法。

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