原发性胆汁性胆管炎合并自身免疫性溶血性贫血1例报告

吴蓉; 冷爱民

doi:10.3969/j.issn.1001-5256.2020.12.030

原发性胆汁性胆管炎合并自身免疫性溶血性贫血1例报告

DOI: 10.3969/j.issn.1001-5256.2020.12.030

吴蓉,
冷爱民

中南大学湘雅医院消化内科

详细信息

中图分类号: R556.6;R575.7
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出版历程
- 出版日期: 2020-12-20

Primary biliary cirrhosis with autoimmune hemolytic anemia: A case report

WU Rong,
LING AiMin

Department of Gastroenterology,Xiangya Hospital,Central South University

摘要

摘要:
<正>原发性胆汁性胆管炎（PBC）是一种慢性肝内胆汁淤积性疾病,其病理特点为进行性、非化脓性、破坏性肝内小胆管炎,最终可发展至肝硬化[1]。80%以上的PBC患者常合并至少1种自身免疫性疾病,其中干燥综合征是较为常见的[2]。而PBC合并自身免疫性溶血性贫血（autoimmune hemolytic anemia,AIHA）的病例报告尚不多,现将中南大学湘雅医院收治的1例PBC合并AIHA病例报告如下,并总结国内外近10年报道的诊断为PBC伴AIHA的8例患者临床资料,对以上9例患者的临床特征、实验室检查结果及治疗转归等方面进行分析,以提高临床医生对本病的认识,旨在为临床诊断与治疗提供更科学的理论依据。
- 肝硬化,胆汁性 /
- 胆汁淤积 /
- 贫血,溶血性,自身免疫性
- liver cirrhosis,biliary /
- cholestasis /
- anemia,hemolytic,autoimmune

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参考文献(27)

[1] Chinese Society of Hepatology,Chinese Medical Association;Chinese Society of Gastroenterology,Chinese Medical Association; Chinese Society of Infectious Diseases,Chinese Medical Association. Consensus on the diagnosis and management of primary biliary cirrhosis(cholangitis)(2015)[J]. J Clin Hepatol,2015,31(12):1980-1988.(in Chinese)．中华医学会肝病学分会，中华医学会消化病学分会，中华医学会感染病学分会．原发性胆汁性肝硬化(又名原发性胆汁性胆管炎)诊断和治疗共识(2015)[J]．临床肝胆病杂志，2015,31(12):1980-1988.

[2] CULP KS,FLEMING CR,DUFFY J,et al. Autoimmune associations in primary biliary cirrhosis[J]. Mayo Clin Proc,1982,57(6):365-370.

[3] Red Blood Cell Disease(Anemia)Group,Chinese Society of Hematology&Chinese Medical Association. Chinese expert consensus on the diagnosis and treatment of autoimmune hemolytic anemia(2017)[J]. Chin J Hematol,2017,38(4):265-267.(in Chinese)．中华医学会血液学分会红细胞疾病(贫血)学组．自身免疫性溶血性贫血诊断与治疗中国专家共识(2017年版)[J]．中华血液学杂志，2017,38(4):265-267.

[4] Abstracts of the Society of General Internal Medicine 33rd Annual Meeting. Minneapolis,Minnesota,USA. April 28-May 1,2010[J]. J Gen Intern Med,2010,25(Suppl 3):s205-s567.

[5] NAKAGAWA T,WATANABE Y,KAGAWA A,et al. Abstracts-APASL 2013[J]. Hepatol Int,2013,7(Suppl 1):717.

[6] KORKMAZ H,BUGDACI MS,TEMEL T,et al. Autoimmune hepatitis-primary biliary cirrhosis overlap syndrome concomitant with immune hemolytic anemia and immune thrombocytopenic purpura(Evans syndrome)[J]. Clin Res Hepatol Gastroenterol,2013,37(2):e45-50.

[7] MEADE S,KOTHA S,GERA A,et al. Autoimmune haemolytic anaemia is a rare association with primary biliary cirrhosis[J].Br J Hosp Med(Lond),2016,77(6):370-371.

[8] GONZALEZ-MORENO EI,MARTINEZ-CABRIALES SA,CRUZ-MORENO MA,et al. Primary biliary cholangitis associated with warm autoimmune hemolytic anemia[J]. J Dig Dis,2016,17(2):128-131.

[9] KUSUMA SH,AKIL F,RIFAI A,et al. Concomitant case of primary biliary cirrhosis and autoimmune hemolityc anemia responding to corticosteroid and ursodeoxycholic acid in young woman[J]. Indonesian J Gastroenterol Hepatol Dig Endosc,2017,17(3):208-211.

[10] ZHAO DT,LIU YM,HAN Y,et al. Fluctuations of antimitochondrial antibodies and anti-gp210 antibody in a patient with primary biliary cholangitis and Sjgren syndrome with subsequent autoimmune hemolytic anemia:A case report[J].Medicine(Baltimore),2020,99(3):e18856.

[11] KARAKOUSIS ND,KOLONIA V,SALTAMAVROS AD,et al.Anemia associated with autoimmune liver disease in a middle-aged female[J]. Arch Hell Med,2019,36(1):114-116.

[12] QU Y,ZHANG W. Role of cell apoptosis in the pathogenesis of primary biliary cholangitis[J]. J Clin Hepatol,2019,35(6):1397-1400.(in Chinese)屈瑶，张玮．细胞凋亡在原发性胆汁性胆管炎发病机制中的作用[J]．临床肝胆病杂志，2019,35(6):1397-1400.

[13] 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.

[14] WANG L,ZHANG FC,CHEN H,et al. Connective tissue diseases in primary biliary cirrhosis:A population-based cohort study[J]. World J Gastroenterol,2013,19(31):5131-5137.

[15] BHANDARI BM,BAYAT H,ROTHSTEIN KD. Primary biliary cirrhosis[J]. Gastroenterol Clin North Am,2011,40(2):373-386,viii.

[16] LIU HL,YANG YF. Clinical and pathological features of primary biliary cholangitis with negative anti-mitochondrial antibody[J]. J Clin Hepatol,2019,35(3):677-680.(in Chinese)刘红丽，杨永峰．抗线粒体抗体阴性的原发性胆汁性胆管炎的临床及病理特征[J]．临床肝胆病杂志，2019,35(3):677-680.

[17] POUPON R. Primary biliary cirrhosis:A 2010 update[J]. J Hepatol,2010,52(5):745-758.

[18] KLEIN NP,RAY P,CARPENTER D,et al. Rates of autoimmune diseases in Kaiser Permanente for usein vaccine adverse event safety studies[J]. Vaccine,2010,28(4):1062-1068.

[19] EATON WW,ROSE NR,KALAYDJIAN A,et al. Epidemiology of autoimmune diseases in Denmark[J]. J Autoimmun,2007,29(1):1-9.

[20] BASS GF,TUSCANO ET,TUSCANO JM. Diagnosis and classification of autoimmune hemolytic anemia[J]. Autoimmun Rev,2014,13(4-5):560-564.

[21] GENTY I,MICHEL M,HERMINE O,et al. Characteristics of autoimmune hemolytic anemia in adults:Retrospective analysis of 83cases[J]. Rev Med Interne,2002,23(11):901-909.

[22] HUME R,WILLIAMSON JM,WHITELAW JW. Red cell survival in biliary cirrhosis[J]. J Clin Pathol,1970,23(5):397-401.

[23] BRACKSTONE M,GHENT CN. Primary biliary cirrhosis and hemolytic anemia confusing serum bilirubin levels[J]. Can J Gastroenterol,2000,14(5):445-447.

[24] FULLER SJ,KUMAR P,WELTMAN M,et al. Autoimmune hemolysis associated with primary biliary cirrhosis responding to ursodeoxycholic acid as sole treatment[J]. Am J Hematol,2003,72(1):31-33.

[25] SPRINGER JE,COLE DE,RUBIN LA,et al. Vitamin D-receptor genotypes as independent genetic predictors of decreased bone mineral density in primary biliary cirrhosis[J].Gastroenterology,2000,118(1):145-151.

[26] KAIBORI M,UCHIDA Y,ISHIZAKI M,et al. Living donor liver transplantion for primary biliary cirrhosis with autoimmune hemolytic anemia:A case report[J]. Dig Dis Sci,2007,52(11):3237-3239.

[27] RETANA AK,KAPLAN MM,ERBAN JK. Autoimmune hemolytic anemia in patients with liver transplants for primary biliary cirrhosis:Three case reports and a review of the literature[J].Am J Gastroenterol,2007,102(1):197-200.

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