Association between rheumatoid arthritis and primary biliary cirrhosis
Association between rheumatoid arthritis and primary biliary cirrhosis
复制标题
DOI：
10.1016/j.jbspin.2006.06.012
复制
发表时间：
2007-05-01
期刊：
影响因子：
4.2
通讯作者：
Allanore, Yannick
中科院分区：
文献类型：
--
作者：
Caramella, Caroline;Avouac, Jerome;Allanore, Yannick
原发性胆汁性肝硬化（PBC）是一种以慢性胆管破坏为特征的自身免疫性疾病，主要累及35 - 45岁的女性。长期的肝脏炎症会导致疤痕，导致肝硬化。最常见的首发临床表现是瘙痒、乏力或黄疸，但大多数患者无症状。PBC本身可能与关节痛有关，但多发性关节炎和滑膜炎除外。PBC通常与其他非肝脏自身免疫性疾病相关，特别是原发性干燥综合征，这可能有利于关节受累。PBC和类风湿性关节炎（RA）已被认为是并存的PBC患者的1.8%至5.6%，但支持这种关联的数据很少。我们报告两个这样的协会的情况下。这两例患者均表现为严重糜烂型RA。我们讨论这些患者的治疗管理，考虑到肝脏受累和药物毒性。(C)2007年，Elsevier Masson SAS。All rights reserved.
Primary biliary cirrhosis (PBC) is an autoimmune disease, characterized by chronic biliary duct destruction, which mainly affects women aged between 35 and 45 years. Prolonged liver inflammation can cause scarring, leading to cirrhosis. The most common first clinical manifestations are pruritus, asthenia or jaundice, but most patients remain asymptomatic. PBC can be associated by itself with arthralgia, but polyarthritis and synovitis are exceptional. PBC is often associated with other non-hepatic autoimmune diseases, especially primary Sjogren's syndrome, which may favour articular involvement. PBC and rheumatoid arthritis (RA) have been suggested to coexist in 1.8 to 5.6% of patients with PBC, but data supporting this association are scarce. We report two cases of such an association. Both of these patients presented severe erosive RA. We discuss the therapeutic management of these patients, taking into account hepatic involvement and drug toxicity. (C) 2007 Elsevier Masson SAS. All rights reserved.