Liver damage in primary biliary cirrhosis and accompanied by primary Sjögren's syndrome: a retrospective pilot study

Cent Eur J Immunol. 2016;41(2):182-7. doi: 10.5114/ceji.2016.60993. Epub 2016 Jul 15.

Abstract

Introduction: Primary biliary cirrhosis (PBC) and primary Sjögren's syndrome (pSS) have been referred to as "generalized autoimmune epithelitis". Indeed, the pathogenic mechanisms, clinical features, and optimal therapeutic approaches for them are not yet fully defined.

Material and methods: A retrospective analysis was carried out on clinical data obtained from 302 inpatients newly diagnosed with PBC, pSS, or the coexistence of PBC and SS between May 2011 and December 2014. Forty-two patients with abnormal hepatic function were divided into the PBC group (n = 17), the coexistent group (PBC accompanied by SS, n = 13), and the pSS group (n = 12). Their clinical symptoms, laboratory data, and pathological features were collected and analyzed when they were first diagnosed. The clinical and laboratory data were collected at 0, 1, and 3 months after treatment.

Results: Of the 42 patients with abnormal liver function, 4 were male and 38 were female patients. Compared with the patients in the PBC group, the patients in the other 2 groups were more likely to have an elevated erythrocyte sedimentation rate (ESR) and serum immunoglobulin G (IgG) levels. Abnormal serum immunoglobulin M levels (IgM) were more frequent in the PBC group. Corticosteroids were effective in normalizing elevated liver enzyme levels in patients with SS and in those with coexistent conditions.

Conclusions: This pilot study suggests that patients with PBC, pSS, and PBC/SS coexistence and having liver function abnormality share similar symptoms, but have different pathogenesis and prognosis.

Keywords: Sjögren's syndrome; autoimmune liver disease; primary biliary cirrhosis.