Publication
Primary biliary cirrhosis in a rheumatoid arthritis patient treated with rituximab, a case-based review
| dc.contributor.author | Polido-Pereira, J | |
| dc.contributor.author | Rodrigues, AM | |
| dc.contributor.author | Canhão, H | |
| dc.contributor.author | Saraiva, F | |
| dc.contributor.author | Pereira da Silva, JA | |
| dc.contributor.author | Fonseca, JE | |
| dc.date.accessioned | 2011-11-15T10:50:29Z | |
| dc.date.available | 2011-11-15T10:50:29Z | |
| dc.date.issued | 2011 | |
| dc.description.abstract | Primary biliary cirrhosis (PBC) is an autoimmune disease in which intrahepatic bile ducts are targeted by an immune-mediated injury. This disease tends to progress to fibrosis and cirrhosis with hepatic failure. The authors report a case of a 50-year-old rheumatoid arthritis (RA) patient, with erosions and seropositive for rheumatoid factor and anti-citrullinated peptide antibodies, with 18 years disease duration refractory to prednisolone and several disease-modifying antirheumatic drugs, either conventional or biological (adalimumab and etanercept). In April 2007, she started therapy with rituximab (RTX) with good European League Against Rheumatism response achieved 9 months later. In June 2008, she was admitted with intrahepatic cholestasis, steatorrhea, and spontaneous fractures of various ribs. After excluding cholelitiasis, as well as infectious and neoplastic diseases a liver biopsy was performed that was compatible with the diagnosis of PBC. The antinuclear antibodies (1/160) were positive as well as the antimitochondrial antibodies (1/640). Other antibodies were negative such as anti-SSA and anti-SSB. Afterwards, the patient started ursodesoxycholic acid 15 mg kg(-1) day(-1) with progressive improvement of cholestatic markers. A labial salivary gland biopsy was performed and showed findings compatible with the concomitant diagnosis of Sjögren's syndrome. Based on this clinical report, a detailed review of the clinical aspects of PBC is presented as well as its association with other immune-mediated inflammatory diseases, particularly, with RA. | por |
| dc.identifier.citation | Clin Rheumatol. 2011 Oct 26. [Epub ahead of print] | por |
| dc.identifier.uri | http://hdl.handle.net/10400.4/1127 | |
| dc.language.iso | eng | por |
| dc.peerreviewed | yes | por |
| dc.publisher | Springer | por |
| dc.subject | Artrite Reumatóide | por |
| dc.subject | Cirrose Biliar Primária | por |
| dc.subject | Rituximab | por |
| dc.title | Primary biliary cirrhosis in a rheumatoid arthritis patient treated with rituximab, a case-based review | por |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| rcaap.rights | openAccess | por |
| rcaap.type | article | por |