Anemia caused by primary biliary cholangitis and special reasons: A case report
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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。目前,熊去氧胆酸是唯一经随机对照临床试验证实治疗本病安全有效的药物[1]。贫血是肝硬化常见表现之一,除非合并上消化道出血或叶酸缺乏,很少引起严重贫血,如果不能找到引起贫血的原因,单纯对症治疗易导致贫血反复发作,因此准确判断贫血病因是治疗的关键。现报道1例PBC合并特殊原因所致反复贫血的病例,以提高对此病的认识。
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关键词:
- 肝硬化,胆汁性 /
- 贫血 /
- 贫血,溶血性,自身免疫性
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Key words:
- liver cirrhosis,biliary /
- anemia /
- anemia,hemolytic,autoimmune
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[1] PARS A. Primary biliary cholangitis[J]. Med Clin(Barc),2018,151(6):242-249. [2] WANG L,HAN Y. An excerpt of primary biliary cholangitis:2018 practice guidance from the American Association for the Study of Liver Disease[J]. J Clin Hepatol,2018,34(11):2300-2304.(in Chinese)王璐,韩英.《2018年美国肝病学会原发性胆汁性胆管炎实践指导》摘译[J].临床肝胆病杂志,2018,34(11):2300-2304. [3] SELMI C,BOWLUS CL,GERSHWIN ME,et al. Primary biliary cirrhosis[J]. The Lancet,2011,377(9777):1600-1609. [4] 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. [5] CHALIFOUX SL,KONYN PG,CHOI G,et al. Extrahepatic manifestations of primary biliary cholangitis[J]. Gut Liver,2017,11(6):771-780. [6] IMAM MH,LINDOR KD. The natural history of primary biliary cirrhosis[J]. Semin Liver Dis,2014,34(3):329-333. [7] ZHANG LL,FAN YJ,TAN B,et al. Recognition of the clinical application and biological mechanism of ursodeoxycholic acid in liver disease[J]. Chin J Clin Pharmacol Ther,2007,22(2):233-240.(in Chinese)张林林,樊玉娟,谭波,等.熊去氧胆酸在慢性肝病中应用及机制的再认识[J].中国临床药理学与治疗学,2007,22(2):233-240. [8] HARMS MH,van BUUREN HR,CORPECHOT C,et al. Ursodeoxycholic acid therapy and liver transplant-free survival in patients with primary biliary cholangitis[J]. J Hepatol,2019,71(2):357-365. [9] TSURMI H,MORIWAKI H. Digestive disease with anemial[J].Nippon Rinsho,2008,66(3):530-533. [10] DOHMEN K,SHIGEMATSU H,MIYAMOTO Y,et al. Atrophic corpus gastritis and Helicobacter pylori infection in primary biliary cirrhosis[J]. Dig Dis Sci,2002,47(1):162-169. [11] SCHOUTEN JN,VERHEIJ J,SEIJO S. Idiopathic non-cirrhotic portal hypertension:A review[J]. Orphanet J Rare Dis,2015,10:67. [12] ZHONG S,LUO L,YUAN CL,et al. Analysis of plasma exchange or infusion induced hemolysis in end-stage patients with liver disease[J]. Chongqing Med,2010,39(12):1538-1539.(in Chinese)钟珊,罗玲,袁春兰,等.血浆置换以及大量血浆输注导致终末期肝病患者溶血性贫血分析[J].重庆医学,2010,39(12):1538-1539. [13] ZANELLA A,BARCELLINI W. Treatment of autoimmune hemolytic anemias[J]. Haematologica,2014,99(10):1547-1554. [14] WEN W,LIU Y,ZHAO C,et al. Clinical and serologic features of primary Sjogren’s syndrome concomitant with autoimmune hemolytic anemia:A large-scale cross-sectional study[J].Clin Rheumatol,2015,34(11):1877-1884. [15] 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. [16] 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.
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