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A case of primary biliary cirrhosis associated with pernicious anemia: a case report.

Jazia EB, Khalifa M, Abdelkader AB, Kaabia N, Ghannouchi N, Braham A, Letaief A, Bahri F - Cases J (2010)

Bottom Line: Mildly elevated serum levels of alkaline phosphatase and gamma-glutamyl transpeptidase were detected.The titer of anti-mitochondrial M(2 )anti-body was elevated.The diagnosis of pernicious anemia was established by megaloblastosis in bone marrow, atrophic gastritis without Helicobacter pylori, low level of vitamin B(12 )and good response to treatment regimen of vitamin B(12).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine and Infectious diseases, University Hospital F Hached,4000, Sousse, Tunisia.

ABSTRACT
Primary biliary cirrhosis is often associated with autoimmune diseases. However, its association with pernicious anemia has rarely been reported.We report a case of a 68-year-old woman who presented jaundice and pruritus. Mildly elevated serum levels of alkaline phosphatase and gamma-glutamyl transpeptidase were detected. The titer of anti-mitochondrial M(2 )anti-body was elevated. Histology of liver biopsy showed features of primary biliary cirrhosis. In addition, aregenerative macrocytic anemia was found in the full blood count. The diagnosis of pernicious anemia was established by megaloblastosis in bone marrow, atrophic gastritis without Helicobacter pylori, low level of vitamin B(12 )and good response to treatment regimen of vitamin B(12). The association of primary biliary cirrhosis and pernicious anemia is unlikely to be casual and may be explained by autoimmune mechanism commonly shared by the diseases.

No MeSH data available.


Related in: MedlinePlus

HE stain × 400: portal infiltrate composed of lymphocytes invading the bile duct epithelium (Arrow) and extension to the peri portal areas (Head of arrow).
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Figure 1: HE stain × 400: portal infiltrate composed of lymphocytes invading the bile duct epithelium (Arrow) and extension to the peri portal areas (Head of arrow).

Mentions: Histological examination of a liver biopsy revealed a portal inflammatory infiltrate mainly composed of lymphocytes invading and destroying the epithelium of bile ducts. Inflammatory cells also extend to the peri-portal areas (Fig. 1). Elsewhere, there was fibrosis peri-portal without regenerative nodules. The bone marrow biopsy showed megaloblastosis. Upper gastro intestinal endoscopy exhibited an atrophy of the gastric mucosa in the body of the stomach. Gastric biopsy specimens showed chronic inflammatory infiltrate into the lamina propria associated with destruction of parietal cells and foci of intestinal metaplasia and glandular atrophy. No Helicobacter pylori was seen


A case of primary biliary cirrhosis associated with pernicious anemia: a case report.

Jazia EB, Khalifa M, Abdelkader AB, Kaabia N, Ghannouchi N, Braham A, Letaief A, Bahri F - Cases J (2010)

HE stain × 400: portal infiltrate composed of lymphocytes invading the bile duct epithelium (Arrow) and extension to the peri portal areas (Head of arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2820004&req=5

Figure 1: HE stain × 400: portal infiltrate composed of lymphocytes invading the bile duct epithelium (Arrow) and extension to the peri portal areas (Head of arrow).
Mentions: Histological examination of a liver biopsy revealed a portal inflammatory infiltrate mainly composed of lymphocytes invading and destroying the epithelium of bile ducts. Inflammatory cells also extend to the peri-portal areas (Fig. 1). Elsewhere, there was fibrosis peri-portal without regenerative nodules. The bone marrow biopsy showed megaloblastosis. Upper gastro intestinal endoscopy exhibited an atrophy of the gastric mucosa in the body of the stomach. Gastric biopsy specimens showed chronic inflammatory infiltrate into the lamina propria associated with destruction of parietal cells and foci of intestinal metaplasia and glandular atrophy. No Helicobacter pylori was seen

Bottom Line: Mildly elevated serum levels of alkaline phosphatase and gamma-glutamyl transpeptidase were detected.The titer of anti-mitochondrial M(2 )anti-body was elevated.The diagnosis of pernicious anemia was established by megaloblastosis in bone marrow, atrophic gastritis without Helicobacter pylori, low level of vitamin B(12 )and good response to treatment regimen of vitamin B(12).

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Internal Medicine and Infectious diseases, University Hospital F Hached,4000, Sousse, Tunisia.

ABSTRACT
Primary biliary cirrhosis is often associated with autoimmune diseases. However, its association with pernicious anemia has rarely been reported.We report a case of a 68-year-old woman who presented jaundice and pruritus. Mildly elevated serum levels of alkaline phosphatase and gamma-glutamyl transpeptidase were detected. The titer of anti-mitochondrial M(2 )anti-body was elevated. Histology of liver biopsy showed features of primary biliary cirrhosis. In addition, aregenerative macrocytic anemia was found in the full blood count. The diagnosis of pernicious anemia was established by megaloblastosis in bone marrow, atrophic gastritis without Helicobacter pylori, low level of vitamin B(12 )and good response to treatment regimen of vitamin B(12). The association of primary biliary cirrhosis and pernicious anemia is unlikely to be casual and may be explained by autoimmune mechanism commonly shared by the diseases.

No MeSH data available.


Related in: MedlinePlus