Antimitochondrial Antibody–Negative Primary Biliary Cholangitis

Chascsa, David M.; Lindor, Keith D.

doi:10.1016/j.cld.2018.03.009

Cited by 15 publications

(18 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Even though AMA are the antibodies classically related to PBC, there is evidence that most patients with positive AMA do not have PBC findings in liver biopsy[ 26 , 27 ]. More than half of PBC cases in our sample were AMA-negative, much higher than in prior reports (5%-18%)[ 28 ]. Evidence that clinical characteristics or response to treatment is different in AMA-negative patients has been inconsistent[ 29 ].…”

Section: Discussioncontrasting

confidence: 72%

Poor performance of anti-mitochondrial antibodies for the diagnosis of primary biliary cholangitis in female Colombian patients: A single-center study

Guatibonza-García¹,

Gaete²,

Pérez-Londoño³

et al. 2021

WJG

View full text Add to dashboard Cite

BACKGROUND Primary biliary cholangitis (PBC) is a serious disease that causes significant morbidity. PBC is confirmed with liver biopsy but autoantibodies are frequently used as proxies for diagnosis. The performance of autoantibodies for the diagnosis of PBC seems to vary widely across populations. AIM To assess the diagnostic performance of several autoantibodies for the diagnosis of PBC in Latin American individuals. METHODS We studied 85 female adult Colombians, 43 cases with biopsy-confirmed PBC and 42 controls in whom a liver biopsy ruled out PBC. Plasma anti-mitochondrial antibodies (AMAs), anti-smooth muscle antibodies (ASMAs) and anti-nuclear antibodies (ANAs), as well as total immunoglobulin (Ig) M and IgG were determined using immunofluorescence or enzyme-linked immunosorbent assay in all study participants within 1 year of the biopsy. For all variables, values analyzed were those closest to the date of the biopsy. Patients with viral or alcoholic hepatitis were excluded. RESULTS Mean age at diagnosis was 58.7 years for cases and 56.9 years for controls, and the body mass index was lower among cases. Most cases received ursodeoxycholic acid, while most controls received vitamin E. Sjögren syndrome and Hashimoto’s thyroiditis were the most frequent autoimmune comorbidities of PBC. The prevalence of AMA positivity among PBC cases was unexpectedly low. The sensitivity and specificity values were respectively 44.2% and 76.2% for AMA, 74.4% and 38.1% for ANA, 14.0% and 73.8% for ASMA, 26.7% and 80.0% for IgG, and 57.1% and 85.7% for IgM. The combination of positive AMA plus positive IgM had 91% positive predictive value for PBC. Among AMA-negative cases, the most prevalent antibodies were ANA (87.5%). In all, 62% of AMA-positive and 84.6% of IgM-positive individuals had fibrosis in their biopsy. CONCLUSION AMA positivity was very low among female Latin American patients with PBC. The performance of all antibodies was quite limited. These results highlight the urgent need for better PBC biomarkers.

show abstract

Section: Discussioncontrasting

confidence: 72%

Poor performance of anti-mitochondrial antibodies for the diagnosis of primary biliary cholangitis in female Colombian patients: A single-center study

Guatibonza-García¹,

Gaete²,

Pérez-Londoño³

et al. 2021

WJG

View full text Add to dashboard Cite

show abstract

“…Одна из теорий включает бактериальную транслокацию из кишечника в желчное дерево (часто ассоциированную с язвенным колитом), основанную на животной модели избыточного бактериального роста. Установлены определенные генные мутации, включая мутации трансмембранного рецептора кистозного фиброза (CFTR), которые также были связаны с развитием ПСХ [8]. Согласно комментариям авторов предложенной схемы развития ПСХ (рис.…”

Section: первичный склерозирующий холангит (псх)unclassified

Autoimmune Cholestatic Lesions of Biliary Ducts

Цыркунов¹,

Прокопчик²,

Andreev³

2021

Hepatol and Gastroenterol

View full text Add to dashboard Cite

show abstract

“…In Western countries and Japan, approximately 85% of PBC patients can be diagnosed in asymptomatic phase, while in other Asian countries only 20-74% patients can be identified in this phase. 9 Fatigue and pruritus are the most common symptoms in PBC. Other clinical symptoms are skin hyperpigmentation, xanthelasma, hyperlipidemia, osteoporosis, and fat-soluble vitamin deficiency.…”

Section: Cholangitis (Pbc)mentioning

confidence: 99%

Clinical, Molecular, and Histopathological Aspect of Primary Biliary Cholangitis

Dameria

Stephanie

Kodariah

et al. 2020

InaJGHE

View full text Add to dashboard Cite

Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is an autoimmune liver disease which tends to be chronic and progressive in nature that is marked by the presence of cholangitis and small size biliary duct destruction which may cause cirrhosis or even liver failure. PBC incidence increases because PBC can now be diagnosed earlier and is due to the increasing survival rate of PBC patients. Diagnosis of PBC can be confirmed in asymptomatic state if in the indirect immunofluorescence (IIF) examination revealed AMA positive, and there is an abnormal liver function. Etiopathogenesis of PBC is multifactorial which involves genetic and environmental factors. Genetic factors which contribute to the incidence of PBC are HLA and non-HLA genes, while in the environmental factors, the triggering factors of PBC are bacterial infection and xenobiotic. Interaction of these factors causes the development of E2 subunit pyruvate dehydrogenase complex (PDC-E2) and antimitochondrial antibody (AMA) as the causing autoantigen of biliary duct desctruction in PBC, mediated by the immune system. PBC stage is divided into minimal, mild, moderate and severe. Ursodeoxycholic acid (UDCA) is the first line therapy for PBC, while obeticholic acid (OCA) and fibrate is used as the second line. Liver transplantation is the definitive therapy for PBC where disease progresses into the advanced stage, although the patients have received medical treatment.

show abstract

Antimitochondrial Antibody–Negative Primary Biliary Cholangitis

Cited by 15 publications

References 50 publications

Poor performance of anti-mitochondrial antibodies for the diagnosis of primary biliary cholangitis in female Colombian patients: A single-center study

Poor performance of anti-mitochondrial antibodies for the diagnosis of primary biliary cholangitis in female Colombian patients: A single-center study

Autoimmune Cholestatic Lesions of Biliary Ducts

Clinical, Molecular, and Histopathological Aspect of Primary Biliary Cholangitis

Contact Info

Product

Resources

About