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Co-existence of primary biliary cirrhosis and ulcerative colitis

Year 2011, Volume: 33 Issue: 3, 374 - 377, 25.01.2011

Abstract

Abstract

A sixty-four years old female patient who had ulcerative colitis for 7 years ago and still under treatment was admitted to the clinic for her refractory pruritus. Laboratory tests revealed elevated liver function tests. Anti-mitochondrial antibody was positive. Her liver biopsy was consistent with primary biliary cirrhosis showing infiltration of portal areas with lymphocytes and histiocytes and convenient treatment was initiated. We present this case report because of the rare co-existence of ulcerative colitis and primary biliary cirrhosis.

Keywords: Ulcerative colitis, primary biliary cirrhosis

 

Özet

Altmış dört yaşında, yedi yıl önce ülseratif kolit tanısı konan ve halen tedavisi devam etmekte olan kadın hasta geçmeyen kaşıntı semptomu ile kliniğe kabul edildi. Yapılan tetkiklerde karaciğer fonksiyon testleri yüksek bulundu. Anti-mitokondrial antikor pozitifti, karaciğer biyopsisinde portal alanların lenfosit ve histiyositlerle infiltre olduğu raporlanarak primer bilier siroz tanısı ile tedavisine başlandı. Ülseratif kolit ve primer bilier siroz hastalığının birlikte nadir görülmesi nedeniyle sunmaktayız.

Anahtar sözcükler: Ülseratif kolit, primer bilier Siroz

References

  • Knight C, Murray KF. Hepatobiliary associations with inflammatory bowel disease. Expert Rev Gastroenterol Hepatol 2009; 3: 681-91.
  • Saich R, Chapman R: Primary sclerosing cholangitis, autoimmune hepatitis and overlap syndromes in inflammatory bowel disease. World J Gastroenterol 2008 21; 14: 331-7.
  • Monsen U, Sorstad J, Hellers G, Johansson C. Extracolonic diagnosis in ulcerative colitis: an epidemiological study. Am J Gastroenterol 1990; 85: 711-6.
  • Ohge H, Takesue Y, Yokoyama T, Hiyama E, Murakami Y, Imamura Y, Shimamoto F, Matsuura Y. Progression of primary biliary cirrhosis after proctocolectomy for ulcerative colitis. J Gastroenterol 2000; 35: 870-2.
  • Koulentaki M, Koutroubakis IE, Petinaki E, Tzardi M, Oekonomaki H, Mouzas I, Kouroumalis EA. Ulcerative colitis associated with primary biliary cirrhosis. Dig Dis Sci 1999; 44: 1953-6.
  • Kato Y, Marimoto H, Unoura M, Kobayashi K, Hattory N, Nakamura Y. Primary biliary cirrhosis and chronic pancreatitis in a patient with ulcerative colitis. J Clin Gastroenterol 1985; 7: 425-7.
  • Bush A, Mitchison H, Walt R, Baron JH, Boylston AW, Summerfield JA. Primary biliary cirrhosis and ulcerative colitis. Gastroenterology 1987; 92: 2009- 13.
  • Akahoshi K, Miyata Y, Hashimoto M, Koga S, Chijiwa Y, Misawa T, Suematsu E, Nishimura J, Nawata H. A case of combined primary biliary cirrhosis, ulcerative colitis and chronic myelocytic leukemia. Gastroenterol Jpn 1992; 27: 252-7.
  • Lever E, Balasubramanian K, Condon S, Wat BY. Primary biliary cirrhosis associated with ulcerative colitis. Am J Gastroenterol 1993; 88: 945-7.
  • Chien RN, Sheen IS, Chen TJ, Liaw YF. A clinicopathological study in primary biliary cirrhosis. J Formos Med Assoc 1992; 91 Suppl 2: pp 117-21.
  • Veloso FT, Dias LM, Carvalho J, Fraga J, Saleiro J. Ulcerative colitis, primary biliary cirrhosis, and chronic pancreatitis: coincident or coexistent? J Clin Gastroenterol 1993; 16: 55-7.
  • Satsangi J, Marshall J, Roskell D, Jewell D. Ulcerative colitis complicated by renal cell carcinoma: a series of three patients. Gut 1996; 38: 148-50.
  • Nakayama M, Tsuji H, Shimono J, Azuma K, Ogata H, Matsumoto T, Aoyagi K, Fujishima M, Iida M. Primary biliary cirrhosis associated with ulcerative colitis. Fukuoka Igaku Zasshi 2001; 92: 354-9.
  • Xiao WB, Liu YL. Primary biliary cirrhosis and ulcerative colitis: a case report and review of literatüre. World J Gastroenterol 2003; 9: 878-80.
  • Arai O, Ikeda H, Mouri H, Notohara K, matsueda K. Two cases of inflammatory bowel disease diagnosed in the course of primary biliary cirrhosis. Nihon Shokakibyo Gakkai Zasshi 2010; 107: 900-8.
  • Williams SM, Harned RK. Hepatobiliary complications of inflammatory bowel disease. Radiol Clin North Am 1987; 25: 175-88.
  • Manousos ON, Giannadaki E, Mouzas I, Tzardi M, Koutroubakis I, Skordilis P, Vasslakis S, Vlachonicolis IG. Ulcerative colitis is as common in Crete as in northern Europe. A 5-year prospective study. Eur J Gastroenterol Hepatol 1996; 8: 893-8.
  • Triger DR, Berg PA, Rodes J. Epidemiology of antimitochondrial antibody seropositivity and primary biliary cirrhosis. Liver 1984; 4: 195-200.
  • Munoz LE, Thomas HC, Scheuer PJ, Doniach D, Sherlock S. Is mitochondrial antibody diagnostic of primary biliary cirrhosis? Gut 1981; 22: 136-40.
  • Satsangi J, Welsh KI, Bunce M, Julier C, Farrant JM, Bell JI, Jewell DP. Contribution of genes of the majör histocompatibility complex to susceptibility and disease phenotype in iflammatory bowel disease. Lancet 1996; 347: 1212-7.

Ulcerative colitis and primary biliary cirrhosis: A case report

Year 2011, Volume: 33 Issue: 3, 374 - 377, 25.01.2011

Abstract

Abstract

A 64 years old female patient who had ulcerative colitis diagnosis established 7 years ago with still ongoing treatment was admitted to being examined on her complaint of pruritus not to regress. On the examinations conducted, her liver function test outcomes were found high. Her anti mitochondrial antibody was positive, and the treatment was introduced on the diagnosis of primary biliary cirrhosis on the liver biopsy report showing the portal areas were infiltrated by the lymphocytes and histiocytes. We present this case report because of the ulcerative colitis with primary biliary cirrhosis is uncommon.

References

  • Knight C, Murray KF. Hepatobiliary associations with inflammatory bowel disease. Expert Rev Gastroenterol Hepatol 2009; 3: 681-91.
  • Saich R, Chapman R: Primary sclerosing cholangitis, autoimmune hepatitis and overlap syndromes in inflammatory bowel disease. World J Gastroenterol 2008 21; 14: 331-7.
  • Monsen U, Sorstad J, Hellers G, Johansson C. Extracolonic diagnosis in ulcerative colitis: an epidemiological study. Am J Gastroenterol 1990; 85: 711-6.
  • Ohge H, Takesue Y, Yokoyama T, Hiyama E, Murakami Y, Imamura Y, Shimamoto F, Matsuura Y. Progression of primary biliary cirrhosis after proctocolectomy for ulcerative colitis. J Gastroenterol 2000; 35: 870-2.
  • Koulentaki M, Koutroubakis IE, Petinaki E, Tzardi M, Oekonomaki H, Mouzas I, Kouroumalis EA. Ulcerative colitis associated with primary biliary cirrhosis. Dig Dis Sci 1999; 44: 1953-6.
  • Kato Y, Marimoto H, Unoura M, Kobayashi K, Hattory N, Nakamura Y. Primary biliary cirrhosis and chronic pancreatitis in a patient with ulcerative colitis. J Clin Gastroenterol 1985; 7: 425-7.
  • Bush A, Mitchison H, Walt R, Baron JH, Boylston AW, Summerfield JA. Primary biliary cirrhosis and ulcerative colitis. Gastroenterology 1987; 92: 2009- 13.
  • Akahoshi K, Miyata Y, Hashimoto M, Koga S, Chijiwa Y, Misawa T, Suematsu E, Nishimura J, Nawata H. A case of combined primary biliary cirrhosis, ulcerative colitis and chronic myelocytic leukemia. Gastroenterol Jpn 1992; 27: 252-7.
  • Lever E, Balasubramanian K, Condon S, Wat BY. Primary biliary cirrhosis associated with ulcerative colitis. Am J Gastroenterol 1993; 88: 945-7.
  • Chien RN, Sheen IS, Chen TJ, Liaw YF. A clinicopathological study in primary biliary cirrhosis. J Formos Med Assoc 1992; 91 Suppl 2: pp 117-21.
  • Veloso FT, Dias LM, Carvalho J, Fraga J, Saleiro J. Ulcerative colitis, primary biliary cirrhosis, and chronic pancreatitis: coincident or coexistent? J Clin Gastroenterol 1993; 16: 55-7.
  • Satsangi J, Marshall J, Roskell D, Jewell D. Ulcerative colitis complicated by renal cell carcinoma: a series of three patients. Gut 1996; 38: 148-50.
  • Nakayama M, Tsuji H, Shimono J, Azuma K, Ogata H, Matsumoto T, Aoyagi K, Fujishima M, Iida M. Primary biliary cirrhosis associated with ulcerative colitis. Fukuoka Igaku Zasshi 2001; 92: 354-9.
  • Xiao WB, Liu YL. Primary biliary cirrhosis and ulcerative colitis: a case report and review of literatüre. World J Gastroenterol 2003; 9: 878-80.
  • Arai O, Ikeda H, Mouri H, Notohara K, matsueda K. Two cases of inflammatory bowel disease diagnosed in the course of primary biliary cirrhosis. Nihon Shokakibyo Gakkai Zasshi 2010; 107: 900-8.
  • Williams SM, Harned RK. Hepatobiliary complications of inflammatory bowel disease. Radiol Clin North Am 1987; 25: 175-88.
  • Manousos ON, Giannadaki E, Mouzas I, Tzardi M, Koutroubakis I, Skordilis P, Vasslakis S, Vlachonicolis IG. Ulcerative colitis is as common in Crete as in northern Europe. A 5-year prospective study. Eur J Gastroenterol Hepatol 1996; 8: 893-8.
  • Triger DR, Berg PA, Rodes J. Epidemiology of antimitochondrial antibody seropositivity and primary biliary cirrhosis. Liver 1984; 4: 195-200.
  • Munoz LE, Thomas HC, Scheuer PJ, Doniach D, Sherlock S. Is mitochondrial antibody diagnostic of primary biliary cirrhosis? Gut 1981; 22: 136-40.
  • Satsangi J, Welsh KI, Bunce M, Julier C, Farrant JM, Bell JI, Jewell DP. Contribution of genes of the majör histocompatibility complex to susceptibility and disease phenotype in iflammatory bowel disease. Lancet 1996; 347: 1212-7.
There are 20 citations in total.

Details

Primary Language English
Journal Section Case Reports
Authors

Sabiye Akbulut

Firdevs Topal

Özlem Yönem

Birol Bostancı

Musa Akoğlu

Publication Date January 25, 2011
Published in Issue Year 2011Volume: 33 Issue: 3

Cite

AMA Akbulut S, Topal F, Yönem Ö, Bostancı B, Akoğlu M. Co-existence of primary biliary cirrhosis and ulcerative colitis. CMJ. September 2011;33(3):374-377.