članak: 1 od 1  
Srpski arhiv za celokupno lekarstvo
2002, vol. 130, br. 5-6, str. 213-216
jezik rada: srpski
prikaz knjige
doi:10.2298/SARH0206213F
Primarna bilijarna ciroza
Filipović Branka, Oprić Miroslav, Miličić Anka, Paranos Svetlana
Univerzitet u Beogradu, Medicinski fakultet, KBC 'Bežanijska kosa'

e-adresa: branka_filipovic@yahoo.com

Sažetak

Primerna bilijarna ciroza je hronično zapaljenje jetre s holestazom, koje se odlikuje promenama na intrahepatičnim žučnim kanalićima u ranim stadijumima i na parenhimu jetre kada je već bolest napredovala. Oboljenje postepeno progreduje u kliničku sliku bilijarne ciroze. Primarna bilijarna ciroza prvenstveno zahvata osobe ženskog pola svih rasa i socijalnog statusa starosti između 35 i 60 godina. Naša bolesnica, žena starosti 78 godina hospitalizovana je radi lečenja hipertrofične kardiomiopatije. U toku rutinskog ispitivanja laboratorijskih analiza, registrovani su znaci holestaze: visoki nivo alkalne fosfataze i gama-glutamil-transferaze kombinovani s trombocitopenijom, verovatno autoimunskog porekla. U serumu je utvrđena hiperholesterolemija (7,8 mmol/L), udružena s normalnim nivoima triglicerida. Glavno dijagnostičko merilo za primarnu bilijarnu cirozu bio je visok titar antimitohondrijskih antitela u serumu, koji je kod naše bolesnice iznosio 1:640. Lek izbora u terapiji primarne bilijarne ciroze jeste ursodeoksiholna kiselina, koji smo primenili kod naše bolesnice. Naša bolesnica s primernom bilijarnom cirozom interesantna je zbog komorbiditeta s oboljenjem srca, koje je prikrivalo oboljenje jetre.

Ključne reči

primarna bilijarna ciroza; antimitohondrijska antitela

Reference

PubMedKoBSON

Akimoto, S., Ishikawa, O., Takagi, H., Miyachi, Y. (1998) Immunological features of patients with primary biliary cirrhosis (PBC) overlapping systemic sclerosis: A comparison with patients with PBC alone. J Gastroenterol Hepatol, 13(9): 897-901

Čvorić, M. (1999) Primarna bilijarna ciroza. u: Teodorović J. i dr. (ur.) Gastroenterologija, Beograd: Excelsior, str. 312-7, III deo

PubMedKoBSON

Ikeda, T., Sato, C., Noguchi, O., Kobayashi, F., Tozuka, S., Sakamoto, S., Marumo, F. (1996) Improvement of peripheral blood lymphocyte subsets in primary biliary cirrhosis after ursodeoxycholic acid therapy. J Gastroenterol Hepatol, 11(4): 366-72

Jorge, A.D., Leuschner, U. (2000) Primary biliary cirrhosis: Aetiology, diagnosis, clinical manifestations, treatment, mechanisms of action. Freeburg: Falk Foundation

PubMedKoBSON

Kiechl, S., Kohlendorfer, U., Willeit, J., Pohl, P., Vogel, W. (1996) Myasthenia gravis and primary biliary cirrhosis. Common immunological features and rare coincidence. Acta Neurol Scand, 93(4): 263-5

PubMedKoBSON

Kitami, N., Komada, T., Ishii, H., Shimizu, H., Adachi, H., Yamaguchi, Y., Kitamura, T., Oide, H., Miyazaki, A., Ishikawa, M. (1995) Immunological study of anti-M2 in antimitochondrial antibody-negative primary biliary cirrhosis. Intern Med, 34(6): 496-501

PubMedKoBSON

Klatskin, G., Kantor, F.S. (1972) Mitochondrial antibody in primary biliary cirrhosis and other diseases. Ann Intern Med, 77(4): 533-41

KoBSON

Klein, R., Berg, P.A. (1984) Organ specific antibodies against liver mitochondria in patients with primary biliary cirrhosis (PBC) and their relatives. Hepatology, 4:750

CrossRefPubMedKoBSON

Koulentaki, M., Koutroubakis, I.E., Petinaki, E., Tzardi, M., Oekonomaki, H., Mouzas, I., Kouroumalis, E.A. (1999) Ulcerative colitis associated with primary biliary cirrhosis. Dig Dis Sci, 44(10): 1953-6

PubMedKoBSON

Maddrey, W.C. (1983) Sarcoidosis and primary biliary cirrhosis. Associated disorders?. N Engl J Med, 308(10): 588-90

CrossRefPubMedKoBSON

Newton, J.L., Jones, D.E., Metcalf, J.V., Park, J.B., Burt, A.D., Bassendine, M.F., James, O.F. (2000) Presentation and mortality of primary biliary cirrhosis in older patients. Age Ageing, 29(4): 305-9

PubMedKoBSON

Nozaki, H. (1992) Experimental study on the effect of ursodeoxycholic acid in liver transplantation. Nippon Geka Gakkai Zasshi, 93(12): 1481-8

CrossRefPubMedKoBSON

O'Donohue, J., Workman, M.R., Rolando, N., Yates, M., Philpott-Howard, J., Williams, R. (1997) Urinary tract infections in primary biliary cirrhosis and other chronic liver diseases. Eur J Clin Microbiol Infect Dis, 16(10): 743-6

CrossRefPubMedKoBSON

Potter, K.N., Thomson, R.K., Hamblin, A., Richards, S.D., Lindsay, J.G., Stevenson, F.K. (2001) Immunogenetic analysis reveals that epitope shifting occurs during B-cell affinity maturation in primary biliary cirrhosis. J Mol Biol, 306(1): 37-46

CrossRefPubMedKoBSON

Strassburg, C.P., Jaeckel, E., Manns, M.P. (1999) Anti-mitochondrial antibodies and other immunological tests in primary biliary cirrhosis. Eur J Gastroenterol Hepatol, 11(6): 595-601

CrossRefPubMedKoBSON

Tsuji, K., Watanabe, Y., van de Water, J., Nakanishi, T., Kajiyama, G., Parikh-Patel, A., Coppel, R., Gershwin, M.E. (1999) Familial primary biliary cirrhosis in Hiroshima. J Autoimmun, 13(1): 171-8