自身免疫性肝病相关性风湿病样及皮肤表现

田辉

doi:10.3969/j.issn.1001-5256.2018.09.041

自身免疫性肝病相关性风湿病样及皮肤表现

DOI: 10.3969/j.issn.1001-5256.2018.09.041

田辉

宣城市人民医院感染科

详细信息

中图分类号: R575
计量
- 文章访问数: 1990
- HTML全文浏览量: 44
- PDF下载量: 360
- 被引次数: 0
出版历程
- 收稿日期: 2018-03-22
- 出版日期: 2018-09-20

Rheumatic and skin manifestations associated with autoimmune liver diseases

Tian Hui

Department of Infectious Diseases, The People's Hospital of Xuancheng City

摘要

摘要: 自身免疫性肝病主要包括自身免疫性肝炎、原发性胆汁性胆管炎、原发性硬化性胆管炎及各种类型的重叠综合征,常与肝外自身免疫性疾病相关。但自身免疫性肝病与风湿性疾病和(或)皮肤病的相关性描述甚少。为此,详尽综述了与自身免疫性肝病相关的风湿病样及皮肤表现,以及一些非特异性抗体的临床意义。对并发风湿性疾病和(或)皮肤病的患者治疗应个体化。
- 肝炎,自身免疫性 /
- 肝硬化,胆汁性 /
- 胆管炎,硬化性 /
- 风湿性疾病 /
- 皮肤表现 /
- 综述
Abstract: Autoimmune liver diseases mainly include autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, and various types of overlap syndromes and are often associated with extrahepatic autoimmune diseases. However, few studies have described the association of autoimmune liver diseases with rheumatic disease and/or skin disease. For this purpose, this article reviews the rheumatic and skin manifestations associated with autoimmune liver diseases in detail and the clinical significance of non-specific antibodies. It is pointed out that individualized treatment should be given to patients with rheumatic disease and/or skin disease.
- hepatitis, autoimmune /
- liver cirrhosis, biliary /
- cholangitis, sclerosing /
- rheumatic diseases /
- skin manifestations /
- review

HTML全文

参考文献(65)

[1]WANG Q, YANG F, MIAO Q, et al.The clinical phenotypes of autoimmune hepatitis:a comprehensive review[J].J Autoimmun, 2016, 66 (1) :98-107.

[2]WONG GW, YEONG T, LAWRENCE D, et al.Concurrent extrahepatic autoimmunity in autoimmune hepatitis:implications for diagnosis, clinical course and long-term outcomes[J].Liver Int, 2017, 37 (3) :449-457.

[3]WONG GW, HENEGHAM MA.Association of extrahepatic manifestations with autoimmune hepatitis[J].Dig Dis, 2015, 33 (Suppl2) :25-35.

[4]van GERVEN NM, VERWER BJ, WITTE BI, et al.Epidemiology and clinical characteristics of autoimmune hepatitis in the Netherlands[J].Scand J Gastroenterol, 2014, 49 (10) :1245-1254.

[5]MURATORI P, LENZI M, CASSANI F, et al.Diagnostic approach to autoimmune hepatitis[J].Expert Rev Clin Immunol, 2017, 13 (8) :769-779.

[6]LIU JJ, ZHANG JX, LI J, et al.Clinical analysis of 39 cases of autoimmune hepatitis[J].Tianjin Med J, 2012, 40 (7) :732-734. (in Chinese) 刘均娟, 张俊霞, 李嘉.自身免疫性肝炎39例临床分析[J].天津医药, 2012, 40 (7) :732-734.

[7]TAO L, HUANG SJ, LI L, et al.Analysis of clinical features of 24patients with autoimmune hepatitis[J].J Guangxi Med Univ, 2014, 31 (3) :456-458. (in Chinese) 陶霖, 黄世江, 李莉, 等.自身免疫性肝炎24例临床特点分析[J].广西医科大学学报, 2014, 31 (3) :456-458.

[8]LI SQ, ZHOU L, ZHANG J, et al.Clinical characteristics of 96patients with autoimmune hepatitis[J].J Tianjin Med Univ, 2015, 21 (3) :239-242. (in Chinese) 李树倩, 周璐, 张洁, 等.96例自身免疫性肝炎患者的临床特征[J].天津医科大学学报, 2015, 21 (3) :239-242.

[9]LI XM, LUO F, MA X, et al.Clinical manifestations and pathological features of autoinnnune hepatitis[J].J Clin Intern Med, 2006, 23 (8) :525-528. (in Chinese) 李新民, 骆帆, 马雄, 等.自身免疫性肝炎的临床特点和病理分析[J].临床内科杂志, 2006, 23 (8) :525-528.

[10]FANG XF, LIN R, LUO LL, et al.Clinical features of patients with autoimmune hepatitis combined with extrahepatic autoimmune diseases[J].Shandong Med J, 2014, 54 (40) :75-77. (in Chinese) 范晓飞, 林睿, 罗莉丽, 等.自身免疫性肝炎合并肝外自身免疫疾病患者的临床特点观察[J].山东医药, 2014, 54 (40) :75-77.

[11]WANG WH, WU GD, XIONG CQ, et al.A case report of overlapping autoimmune hepatitis with multiple dermatomyositis[J].Chin Hepatol, 2014, 19 (3) :233. (in Chinese) 王文虎, 吴国栋, 熊昌清, 等.自身免疫性肝炎重叠多发性皮肌炎1例[J].肝脏, 2014, 19 (3) :233.

[12]LEUNG J, DOWLING L, OBADAN I, et al.Risk of non-melanoma skin cancer in autoimmune hepatitis[J].Dig Dis Sci, 2010, 55 (11) :3218-3223.

[13]WERNER M, ALMER S, PRYTZ H, et al.Hepatic and extrahepatic malignancies in autoimmune hepatitis.A long-term followup in 473 Swedish patients[J].J Hepatol, 2009, 50 (2) :388-393.

[14]JENSEN P, EGEBERG A, GISLASON G, et al.Increased risk of autoimmune hepatitis in patients with psoriasis:a Danish Nationwide Cohort Study[J].J Invest Dermatol, 2016, 136 (7) :1515-1517.

[15]ZACHOU K, GATSELIS NK, ARVANITI P, et al.A real-world study focused on the long-term efficacy of mycophenolate mofetil as first-line treatment of autoimmune hepatitis[J].Aliment Pharmacol Ther, 2016, 43 (10) :1035-1047.

[16]ABE M, MASHIBA T, ZENIYA M, et al.Present status of autoimmune hepatitis in Japan:a nationwide survey[J].J Gastroenterol, 2011, 46 (9) :1136-1141.

[17]AL-CHALABI T, BOCCATO S, PORTMANN BC, et al.Autoimmune hepatitis (AIH) in the elderly:a systematic retrospective analysis of a large group of consecutive patients with definite AIH followed at a tertiary referral centre[J].J Hepatol, 2006, 45 (4) :575-583.

[18]CHOUDHURI G, SOMANI SK, BADA CS, et al.Autoimmune hepatitis in India:profile of an uncommon disease[J].BMC Gastroenterol, 2005, 5:27.

[19]AMARAPURKAR DN, PATEL ND.Spectrumof autoimmune liver diseases in western India[J].J Gastroenterol Hepatol, 2007, 22 (12) :2112-2117.

[20]MURATORI P, FABBRI A, LALANNE C, et al.Autoimmune liver disease and concomitant extrahepatic autoimmune disease[J].Eur J Gastroenterol Hepatol, 2015, 27 (10) :1175-1179.

[21]BITTENCOURT PL, FARIAS AQ, PORTA G, et al.Frequency of concurrent autoimmune disorders in patients with autoimmune hepatitis:effect of age, gender, and genetic background[J].J Clin Gastroenterol, 2008, 42 (30) :300-305.

[22]KAVEHMANESH Z, BEIRAGHDARR F, SABURI A, et al.Pediatric autoimmune hepatitis in a patient who presented with erythema nodosum:a case report[J].Hepat Mon, 2012, 12 (1) :42-45.

[23]XENOPHONTOS E, IOANNOU A, CONSTANTINIDES T, et al.Sweet syndrome on a patient with autoimmune hepatitis on azathioprine and CMV infection[J].Oxf Med Case Rep, 2016, 2016 (2) :24-27.

[24]MENDEZ-FLORES S, CHARLI-JOSEPH Y, SAEB-LIMA M, et al.Amicrobial pustulosis of the folds associated with autoimmune disorders:systemic lupus erythematosus case series and first report on the association with autoimmune hepatitis[J].Dermatology, 2013, 226 (1) :1-4.

[25]DANTAS SG, QUINTELLA LP, FERNANDES NC.Exuberant pyoderma gangrenosum in a patient with autoimmune hepatitis[J].An Bras Dermatol, 2017, 92 (1) :114-117.

[26]POWELL FC, SCHROETER AL, WP S, et al.Pyoderma gangrenosum:a review of 86 patients[J].Q J Med, 1985, 55 (217) :173-186.

[27]BINUS AM, QURESHI AA, LI VW, et al.Pyoderma gangrenosum:a retrospective review of patient characteristics, comorbidities and therapy in 103 patients[J].Br J Dermatol, 2011, 165 (6) :1244-1250.

[28]CARD TR, LANGAN SM, CHU TP.Extra-gastrointestinal manifestations of inflammatory bowel disease may be less common than previously reported[J].Dig Dis Sci, 2016, 61 (9) :2619-2626.

[29]CZAJA AJ.Autoantibodies as prognostic markers in autoimmune liver disease[J].Dig Dis Sci, 2010, 55 (8) :2144-2161.

[30]ZHAO Y, YAN HP, TAN YF, et al.Significance of antibody double-stranded DNA in autoimmune hepatitis[J].Chin J Microbiol Immunol, 2008, 28 (7) :639-642. (in Chinese) 赵艳, 闫惠平, 檀玉芬, 等.ds DNA抗体检测对自身免疫性肝炎的临床意义[J].中华微生物学和免疫学杂志, 2008, 28 (7) :639-642.

[31]SUN LM, YAN HP, FENG X, et al.Antibody to R052 in patients with type I autoimmune hepatitis[J].Chin J Lab Diagn, 2014, 18 (2) :236-239. (in Chinese) 孙丽梅, 闫惠平, 冯霞, 等.I型自身免疫性肝炎患者抗R052抗体的检测及临床意义[J].中国实验诊断学, 2014, 18 (2) :236-239.

[32]KONG XS, YAN HP, LIAO HY, et al.Detection of anti-neutrophil cytoplasmic antibodies in autoimmune hepatitis[J].Beijing Med J, 2010, 32 (12) :947-950. (in Chinese) 孔祥沙, 闫惠平, 廖慧钰, 等.抗中性粒细胞胞浆抗体对自身免疫性肝炎的检测意义[J].北京医学, 2010, 32 (12) :947-950.

[33] FLOREANI A, FRANCESCHET I, CAZZAGON N, et al.Extrahepatic autoimmune conditions associated with primary biliary cirrhosis[J].Clin Rev Allergy Immunol, 2015, 48 (2-3) :192-197.

[34]MILLS P, MACSWEEN RN, WATKINSON G.Arthritis and primary biliary cirrhosis[J].Br Med J, 1977, 2 (6096) :1224.

[35] GU EL, YAO GB.The clinical characteristics of primary biliary cirrhosis in China:a sysfimafic review[J].Chin J Hepatol, 2009, 17 (11) :861-866. (in Chinese) 顾而立, 姚光弼.中国人原发性胆汁性肝硬化的临床特点:52年文献的系统分析[J].中华肝脏病杂志, 2009, 17 (11) :861-866.

[36]LIU SL, YANG Z, HU QM, et al.Primary biliary cirrhosis associated with primary Sjogren’s syndrome:a case report and literature review[J].J Clin Hepatol, 2015, 31 (10) :1718-1721. (in Chinese) 刘沙利, 杨政, 胡勤明, 等.原发性胆汁性肝硬化合并原发性干燥综合征1例报告并文献复习[J].临床肝胆病杂志, 2015, 31 (10) :1718-1721.

[37]KUNG YY, TSAI CY, TSAI YY, et al.Enthesopathy in a case of primary biliary cirrhosis with positive HLA-B27[J].Clin Exp Rheumatol, 1997, 15 (6) :708-709.

[38]MAEDA MH, TSUJI S, SHIMIZU J.Inflammatory myopathies associated with antimitochondrial antibodies[J].Brain, 2012, 135 (6) :1767-1777.

[39]TSIANOS EV, HOOFNAGLE JH, FOX PC, et al.Sjogren’s syndrome in patients with primary biliary cirrhosis[J].Hepatology, 1990, 11 (5) :730-734.

[40]LIBERAL R, GRANT CR, SAKKAS L, et al.Diagnostic and clinical significance of anti-centromere antibodies in primary biliary cirrhosis[J].Clin Res Hepatol Gastroenterol, 2013, 37 (6) :572-585.

[41]LIU RR, LI MT, FEl YY, et al.Clinical features of primary binary cirrhosis associated with systemic sclerosis[J].Chin J Rheumatol, 2010, 14 (11) :746-749. (in Chinese) 刘润荣, 李梦涛, 费允云, 等.系统性硬化病合并原发性胆汁性肝硬化的临床分析及文献复习[J].中华风湿病学杂志, 2010, 14 (11) :746-749.

[42]WANG L, GAO LX, ZHANG FC.Primary binary cirrhosis associatied with polymyositis[J].Chin J Rheumatol, 2011, 15 (3) :172-174. (in Chinese) 王立, 高丽霞, 张奉春.多发性肌炎合并原发性胆汁性肝硬化十例临床分析[J].中华风湿病学杂志, 2011, 15 (3) :172-174.

[43]SUN HY, WU B, CHEN LY, et al.Primary sjogren syndrome associated with antiphospholipid syndrome and primary biliary cirrhosis:a case report[J].Chin Mod Doctor, 2007, 45 (19) :144-145. (in Chinese) 孙华瑜, 巫斌, 陈莉滢, 等.原发性干燥综合征伴抗磷脂综合征和原发性胆汁性肝硬化1例[J].中国现代医生, 2007, 45 (19) :144-145.

[44]LI L, LIU XM, ZHAO XG.Primary binary cirrhosis with retroperitoneal fibrosis:a case report[J].J Pract Med, 2011, 27 (16) :3094. (in Chinese) 李丽, 刘晓敏, 赵学刚.原发性胆汁性肝硬化合并腹膜后纤维化1例[J].实用医学杂志, 2011, 27 (16) :3094.

[45]LEI JJ, ZHOU L, CHEN J.Primary biliary cirrhosis complicated with sarcoidosis:one-case analysis[J].World Chin J Dig, 2009, 17 (1) :106-108. (in Chinese) 雷静静, 周力, 陈佳.原发性胆汁性肝硬化并结节病1例[J].世界华人消化杂志, 2009, 17 (1) :106-108.

[46]WANG SX, PU J, CUI LH.A case of primary biliary cirrhosis complicated with Castleman disease[J].Natl Med J China, 2011, 91 (20) :1440. (in Chinese) 王少鑫, 浦江, 崔立红.原发性胆汁性肝硬化合并Castleman病一例[J].中华医学杂志, 2011, 91 (20) :1440.

[47]TERZIROLI BERETTA-PICCOLI B, GUILLOD C, MARSTELLER I, et al.Primary biliary cholangitis associated with skin disorders:a case report and review of the literature[J].Arch Immunol Ther Exp (Warsz) , 2017, 65 (4) :299-309.

[48]MARZANO AV, RAMONI S, CAPUTO R.Amicrobial pustulosis of the folds.Report of 6 cases and a literature review[J].Dermatology, 2008, 216 (4) :305-311.

[49]CORPECHOT C, CHRETIEN Y, CHAZOUILLERES O, et al.Demographic, lifestyle, medical and familial factors associated with primary biliary cirrhosis[J].J Hepatol, 2010, 53 (1) :162-169.

[50]PRINCE MI, DUCKER SJ, JAMES OF.Case-control studies of risk factors for primary biliary cirrhosis in two United Kingdom populations[J].Gut, 2010, 59 (4) :508-512.

[51]GERSHWIN ME, SELMI C, WORMAN HJ, et al.Risk factors and comorbidities in primary biliary cirrhosis:a controlled interviewbased study of 1032 patients[J].Hepatology, 2005, 42 (5) :1194-1202.

[52]HUANG FL, DIAO MY, QIN BD, et al.Meta-analysis of diagnostic value of anti-GP210 antibody detection in Chinese population for primary biliary cirrhosis[J].Int J Lab Med, 2013, 34 (12) :1508-1510. (in Chinese) 黄凤楼, 刁孟元, 秦保东, 等.抗GP210抗体检测对中国人群原发性胆汁性肝硬化诊断价值的meta分析[J].国际检验医学杂志, 2013, 34 (12) :1508-1510.

[53]CHAN HL, LEE YS, HONG HS, et al.Anticentromere antibodies (ACA) :clinical dis-tribution and disease specificity[J].Clin Exp Dermatol, 1994, 19 (4) :298-302.

[54] LIBERAL R, GRANT CR, SAKKAS L, et al.Diagnostic and clinical significance of anti-centromere antibodies in primary biliary cirrhosis[J].Clin Res Hepatol Gastroenterol, 2013, 37 (6) :572-585.

[55]GUILLN-DEL CASTILLO A, CALLEJAS-MORAGA EL, GARCA G, et al.High sensitivity and negative predictive value of the DETECTalgorithm for an early diagnosis of pulmonary arterial hypertension in systemic sclerosis:application in a single center[J].Arthritis Res Ther, 2017, 19 (1) :135.

[56]SHI XH, ZHANG FC, ZHANG X.Significance of anticentromere antibody in primary biliary cirrhosis[J].Chin J Rheumatol, 2006, 10 (8) :485-487. (in Chinese) 史旭华, 张奉春, 张炬.抗着丝点抗体在原发性胆汁性肝硬化中的意义[J].中华风湿病学杂志, 2006, 10 (8) :485-487.

[57]SHEN M, ZHANG X, ZHANG FC.Primary biliary cirrhosis complicated by pulmonary arterial hypertension:a clinical analysis[J].Natl Med J China, 2005, 85 (14) :946-948. (in Chinese) 沈敏, 张烜, 张奉春.原发性胆汁性肝硬化合并肺动脉高压的临床分析[J].中华医学杂志, 2005, 85 (14) :946-948.

[58]FLOREANI A, FRANCESCHET I, CAZZAGON N, et al.Extrahepatic autoimmune conditions associated with primary biliary cirrhosis[J].Clin Rev Allergy Immunol, 2015, 48 (2-3) :192-197.

[59]AGMON-LEVIN N, SHAPIRA Y, SELMI C, et al.A comprehensive evaluation of serum autoantibodies in primary biliary cirrhosis[J].J Autoimmun, 2010, 34 (1) :55-58.

[60]von LANDENBERG P, BAUMGARTHER M, SCHOELMERICH J, et al.Clinical relevance of antiphospholipid antibodies in primary biliary cirrhosis[J].Ann N Y Acad Sci, 2005, 1051 (1) :20-28.

[61]CIESEK S, BECKER T, MANNS MP, et al.Anti-parietal cell autoantibodies (PCA) in primary biliary cirrhosis:a putative m arker for recurrence after orthotopic liver transplantation?[J].Ann Hepatol, 2010, 9 (2) :181.

[62]PALMELA C, PEERANI F, CASTANEDA D, et al.Inflammatory bowel disease and primary sclerosing cholangitis:a review of the phenotype and associated specific features[J].Gut Liver, 2018, 12 (1) :17-29.

[63]XU X, SU L, GAO Y, et al.The prevalence of nonalcoholic fatty liver disease and related metabolic comorbidities was associated with age at onset of moderate to severe plaque psoriasis:a cross-sectional study[J].PLo S One, 2017, 12 (1) :e0169952.

[64]CHIBA M, TOBORI F, YAGISAWA H, et al.A Japanese case of ulcerative colitis associated with dermatitis herpetiformis and primary sclerosing cholangitis[J].Inflamm Bowel Dis, 1996, 2 (5) :255-259.

[65]RUPP C, MUMMELTHEI A, SAUER P, et al.Non-IBD immunological diseases are a risk factor for reduced survival in PSC[J].Liver Int, 2013, 33 (1) :86-93.

施引文献

资源附件(0)

访问统计