Detalhes do Documento

Primary biliary cirrhosis in a rheumatoid arthritis patient treated with rituxi...

Autor(es): Polido-Pereira, J cv logo 1 ; Rodrigues, AM cv logo 2 ; Canhão, H cv logo 3 ; Saraiva, F cv logo 4 ; Pereira da Silva, JA cv logo 5 ; Fonseca, JE cv logo 6

Data: 2011

Identificador Persistente: http://hdl.handle.net/10400.4/1127

Origem: Repositório do Centro Hospitalar e Universitário de Coimbra

Assunto(s): Artrite Reumatóide; Cirrose Biliar Primária; Rituximab


Descrição
Primary biliary cirrhosis (PBC) is an autoimmune disease in which intrahepatic bile ducts are targeted by an immune-mediated injury. This disease tends to progress to fibrosis and cirrhosis with hepatic failure. The authors report a case of a 50-year-old rheumatoid arthritis (RA) patient, with erosions and seropositive for rheumatoid factor and anti-citrullinated peptide antibodies, with 18 years disease duration refractory to prednisolone and several disease-modifying antirheumatic drugs, either conventional or biological (adalimumab and etanercept). In April 2007, she started therapy with rituximab (RTX) with good European League Against Rheumatism response achieved 9 months later. In June 2008, she was admitted with intrahepatic cholestasis, steatorrhea, and spontaneous fractures of various ribs. After excluding cholelitiasis, as well as infectious and neoplastic diseases a liver biopsy was performed that was compatible with the diagnosis of PBC. The antinuclear antibodies (1/160) were positive as well as the antimitochondrial antibodies (1/640). Other antibodies were negative such as anti-SSA and anti-SSB. Afterwards, the patient started ursodesoxycholic acid 15 mg kg(-1) day(-1) with progressive improvement of cholestatic markers. A labial salivary gland biopsy was performed and showed findings compatible with the concomitant diagnosis of Sjögren's syndrome. Based on this clinical report, a detailed review of the clinical aspects of PBC is presented as well as its association with other immune-mediated inflammatory diseases, particularly, with RA.
Tipo de Documento Artigo
Idioma Inglês
delicious logo  facebook logo  linkedin logo  twitter logo 
degois logo
mendeley logo

Documentos Relacionados



    Financiadores do RCAAP

Fundação para a Ciência e a Tecnologia Universidade do Minho   Governo Português Ministério da Educação e Ciência Programa Operacional da Sociedade do Conhecimento União Europeia