title: Changes in titers of antimitochondrial and antinuclear antibodies during the course of primary biliary cirrhosis.
abstract: A case of primary biliary cirrhosis (PBC) in whom a complete biochemical (serum bilirubin, transaminases and alkaline phosphatase) remission was noted after combination treatment with ursodeoxycholic acid (UDCA) and corticosteroid is reported. The antimitochondrial antibody (AMA) detected by indirect immunofluorescence was initially positive, and the antinuclear antibody (ANA) was negative, but these two antibodies subsequently fluctuated independently (AMA-positive/ANA-negative, AMA-negative/ANA-negative, AMA-negative/ANA-positive, AMA-positive/ANA-positive, and again AMA-negative/ANA-positive) in spite of a lack of histopathological improvement in the liver after treatment. The clinical presentation in our case suggests that in some cases the diagnosis of PBC or so-called autoimmune cholangitis (AIC) might depend on the 'phase' of the same disease. Our results also suggest that detailed immunoreactive profiles against 2-oxo-acid dehydrogenase complex (2-OADC) enzymes by using immunoblotting, together with a serial histological examination, should provide more precise information for a diagnosis of PBC.
authors.affiliation: Second Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Masuda
authors.forename: K
authors.initials: K
authors.lastname: Omagari
authors.forename: I
authors.initials: I
authors.lastname: Matsuo
authors.forename: H
authors.initials: H
authors.lastname: Kinoshita
authors.forename: K
authors.initials: K
authors.lastname: Sakimura
authors.forename: H
authors.initials: H
authors.lastname: Hazama
authors.forename: K
authors.initials: K
authors.lastname: Ohba
authors.forename: H
authors.initials: H
authors.lastname: Isomoto
authors.forename: K
authors.initials: K
authors.lastname: Murase
authors.forename: I
authors.initials: I
authors.lastname: Murata
authors.forename: S
authors.initials: S
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000906:Antibodies / Q000032:analysis; D000974:Antibodies, Antinuclear / Q000276:immunology*; D005260:Female; D006680:HLA Antigens / Q000276:immunology; D006801:Humans; D015151:Immunoblotting; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis / Q000276:immunology*; D008928:Mitochondria / Q000276:immunology*
chemical_list: D000906:Antibodies; D000974:Antibodies, Antinuclear; D006680:HLA Antigens