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Dig Dis Sci (2007) 52:35303531 DOI 10.1007/s10620-006-9356-1
LETTER TO THE EDITOR
A Rare Association of Primary Biliary Cirrhosis With Antiphopholipid Antibody Syndrome
V. Gupta B. Balar E. Gbadehan L. K. Orleans L. A. Ozick
Received: 20 March 2006 / Accepted: 25 March 2006 / Published online: 6 April 2007
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Springer Science+Business Media, Inc. 2007
To the Editor: Primary biliary cirrhosis (PBC) is a chronic and progressive, nonsuppurative, cholestatic disease of the liver characterized by antimitochodrial antibodies (AMA) and septal and interlobular bile duct destruction. A number of extrahepatic autoimmune diseases have been previously described. Antiphospholipid antibody syndrome (APLS) is another autoimmune syndrome that may be more commonly associated with PBC than previously recognized. We report a rare case of PBC association with APLS.
In March 2003, a 48-year-old Hispanic male was referred to our clinic for increasing fatigue, pruritus, and hypermelanotic skin. Physical examination revealed cachexia and mild jaundice. Total bilirubin was 2.2 mg/dl (normal, <1.1), aspirate aminotransferases (AST) 64 IU/L (normal, <37), alanine aminotransferases (ALT) 54 IU/L (normal, <40), alkaline phosphatase 588 IU/L (normal, <260), glutamyl transferase 340 IU/L (normal, <55), PT 14 sec, IgG, 2600 mg/dl, IgM, 256 mg/dl. Viral serology was negative for anti-HAV IgM, HbsAg, anti-HBc IgM, and anti-HCV. Serum HCV RNA (by RT-PCR) and HBV DNA (by RT-PCR) were negative. Although serum autoantibodies for ANA and AMA were both positive (1:80 and 1:320, respectively), ASMA was negative. Other tests, including...