title: [Two cases of primary biliary cirrhosis accompanied with severe keratoconjunctivitis sicca due to Sjögren syndrome].
abstract: BACKGROUND
  Primary biliary cirrhosis(PBC) is occasionally associated with Sjögren syndrome and results in liver cirrhosis. It occurs particularly in women, middle-aged or older, and is characterized by the presence of anti-mitochondrial antibody (AMA). We diagnosed PBC in 2 patients with severe keratoconjunctivitis sicca (KCS). CASE 1: A 45-year-old woman was diagnosed with PBC. A test for the presence of AMA was positive and liver dysfunction was detected. Tests for the presence of anti-SSA antibody and anti-SSB antibody were also positive. Signs of severe sicca syndrome observed in the oral cavity and in the eyes were compatible with signs of Sjögren syndrome. Furthermore, superior limbic keratoconjunctivitis was also observed. CASE 2: A 57-year-old woman was diagnosed with PBC and Sjögren syndrome. She also had thyroiditis and severe KCS. Tests for the presence of AMA, anti-SSA antibody, and anti-SSB antibody were positive. In both cases, eye drops were not effective as a treatment for the KCS, but lacrimal punctal occlusion with cauterization was effective.
  
  
  CONCLUSIONS
  PBC should be looked on as a disease that may possibly promote severe KCS.
authors.affiliation: Department of Ophthalmology, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa 920-0293, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Sakamoto
authors.forename: Kazuko
authors.initials: K
authors.lastname: Kitagawa
authors.forename: Aya
authors.initials: A
authors.lastname: Fujisawa
authors.forename: Susumu
authors.initials: S
authors.lastname: Sugai
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Masaki
mesh_terms: D005260:Female; D006801:Humans; D007638:Keratoconjunctivitis Sicca / Q000209:etiology*; D008105:Liver Cirrhosis, Biliary / Q000150:complications*; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000150:complications*