title: Association of primary biliary cirrhosis with idiopathic thrombocytopenic purpura.
abstract: Although both primary biliary cirrhosis (PBC) and idiopathic thrombocytopenic purpura (ITP) are autoimmune diseases, the association of the 2 diseases is rare. Here, we report a case of ITP that developed during the follow-up of PBC in a 74-year-old man. The patient had been diagnosed with PBC 12 years previously, and had received treatment with ursodeoxycholic acid. The platelet count decreased from approximately 60 x 10(9)/L to 8 x 10(9)/L, and the association of decompensated liver cirrhosis (PBC) with ITP was diagnosed. Steroid and immune gamma globulin therapy were successful in increasing the platelet count. Interestingly, human leukocyte antigen genotyping detected the alleles DQB1*0601 and DRB1*0803, which are related to both PBC and ITP in Japanese patients. This case suggests common immunogenetic factors might be involved in the development of PBC and ITP.
authors.affiliation: Department of Internal Medicine, Center for Liver Diseases, Kawasaki Hospital, Kawasaki Medical School, 2-1-80 Nakasange, Okayama 7008505, Japan. n.toshikuni@gmail.com
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Toshikuni
authors.forename: Ryumei
authors.initials: R
authors.lastname: Yamato
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Kobashi
authors.forename: Ken
authors.initials: K
authors.lastname: Nishino
authors.forename: Nobu
authors.initials: N
authors.lastname: Inada
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Sakanoue
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Suehiro
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Fujimura
authors.forename: Gotaro
authors.initials: G
authors.lastname: Yamada
mesh_terms: D000368:Aged; D002756:Cholagogues and Choleretics / Q000627:therapeutic use; D006683:HLA-DQ Antigens / Q000235:genetics; D059866:HLA-DQ beta-Chains; D006684:HLA-DR Antigens / Q000235:genetics; D059811:HLA-DRB1 Chains; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008105:Liver Cirrhosis, Biliary / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D008297:Male; D010976:Platelet Count; D016553:Purpura, Thrombocytopenic, Idiopathic / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D013256:Steroids / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use
chemical_list: D002756:Cholagogues and Choleretics; D006683:HLA-DQ Antigens; D059866:HLA-DQ beta-Chains; C069051:HLA-DQB1 antigen; D006684:HLA-DR Antigens; D059811:HLA-DRB1 Chains; C466440:HLA-DRB1*08:01 antigen; D016756:Immunoglobulins, Intravenous; D013256:Steroids; D014580:Ursodeoxycholic Acid