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Autoimmune cholangitis: A variant of primary biliary cirrhosis

Clinicopathologic and serologic correlations in 200 cases

  • Liver: Cirrhosis, Fibrosis, Portal Hypertension, And Transplantation
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Abstract

The term “autoimmune cholangitis” is used for a disease with clinical and pathologic features of primary biliary cirrhosis (PBC) but with negative anti-mitochondrial antibody (AMA) and positive anti-nuclear antibody (ANA) tests. In order to characterize autoimmune cholangitis and to determine whether this truly differs from PBC, we reviewed 200 cases morphologically consistent with PBC in which data on AMA and ANA status were available to us. Of these, 64 (32%) had a negative AMA, 114 (57%) had a positive ANA, and 40 (20%) had negative AMA and positive ANA (autoimmune cholangitis). The AMA-negative group was slightly younger on average (50 vs 55 years) than AMA positives (P<0.05). There were no significant differences in gender (15.5% male overall), hepatic histopathology, or other laboratory tests between the groups of patients with any of the 4 possible combinations of AMA and ANA. Since the only consistently distinguishing feature among these patients is the autoantibody (AMA and ANA) profile, and they otherwise have virtually identical clinical and histopathologic features, autoimmune cholangitis can be considered to be the same as AMA-negative PBC.

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Authors and Affiliations

  1. From the Division of Hepatic Pathology and the Veterans Administration Special Reference Laboratory for Pathology, Armed Forces Institute of Pathology, Washington, DC

    Zachary D. Goodman MD, PhD, Peter R. McNally DO, Dirk R. Davis MD & Kamal G. Ishak MD, PhD

  2. Division of Gastroenterology, Fitzsimons Army Medical Center, Aurora, Colorado

    Zachary D. Goodman MD, PhD, Peter R. McNally DO, Dirk R. Davis MD & Kamal G. Ishak MD, PhD

Authors
  1. Zachary D. Goodman MD, PhD
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  2. Peter R. McNally DO
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  3. Dirk R. Davis MD
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  4. Kamal G. Ishak MD, PhD
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army or the Department of Defense.

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Goodman, Z.D., McNally, P.R., Davis, D.R. et al. Autoimmune cholangitis: A variant of primary biliary cirrhosis. Digest Dis Sci 40, 1232–1242 (1995). https://doi.org/10.1007/BF02065530

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  • DOI: https://doi.org/10.1007/BF02065530

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