TY - JOUR
T1 - Increased risks of spontaneous bacterial peritonitis and interstitial lung disease in primary biliary cirrhosis patients with concomitant Sjögren syndrome
AU - Chen, Chun-Ting
AU - Tseng, Yu-Chen
AU - Yang, Chih-Wei
AU - Lin, Hsuan-Hwai
AU - Chen, Peng-Jen
AU - Huang, Tien-Yu
AU - Shih, Yu-Lueng
AU - Chang, Wei-Kuo
AU - Hsieh, Tsai-Yuan
AU - Chu, Heng-Cheng
N1 - Export Date: 22 March 2016
CODEN: MEDIA
通訊地址: Chu, H.-C.No. 252, Wu-Xing Street, Xinyi District 110, Taiwan; 電子郵件： [email protected]
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Respective epitopic specificity patterns of antihuman thyroglobulin autoantibodies in patients with Sjogren's syndrome and patients with Hashimoto's thyroiditis (1991) Arthritis Rheum, 34, pp. 1585-1593; Aasarod, K., Haga, H.J., Berg, K.J., Renal involvement in primary Sjogren's syndrome (2000) Clin J Am Soc Nephrol, 93, pp. 297-304; Vitali, C., Tavoni, A., Sciuto, M., Renal involvement in primary Sjogren's syndrome: A retrospective-prospective study (1991) Scand J Rheumatol, 20, pp. 132-136; Matsumura, R., Kondo, Y., Sugiyama, T., Immunohistochemical identification of infiltrating mononuclear cells in tubulointerstitial nephritis associated with Sjogren's syndrome (1988) Clin Nephrol, 30, pp. 335-340; Salaffi, F., Manganelli, P., Carotti, M., A longitudinal study of pulmonary involvement in primary Sjogren's syndrome: Relationship between alveolitis and subsequent lung changes on high-resolution computed tomography (1998) Bri J Rheumatol, 37, pp. 263-269; Davidson, B.K., Kelly, C.A., Griffiths, I.D., Ten year follow up of pulmonary function in patients with primary Sjogren's syndrome (2000) Ann Rheum Dis, 59, pp. 709-712; Wallace, J.G., Jr., Tong, M.J., Ueki, B.H., Pulmonary involvement in primary biliary cirrhosis (1987) J Clin Gastroenterol, 9, pp. 431-435; Guarner, C., Runyon, B.A., Young, S., Intestinal bacterial overgrowth and bacterial translocation in cirrhotic rats with ascites (1997) J Hepatol, 26, pp. 1372-1378; Runyon, B.A., Morrissey, R.L., Hoefs, J.C., Opsonic activity of human ascitic fluid: A potentially important protective mechanism against spontaneous bacterial peritonitis (1985) Hepatology (Baltimore, Md), 5, pp. 634-637; Runyon, B.A., Low-protein concentration ascitic fluid is predisposed to spontaneous bacterial peritonitis (1986) Gastroenterology, 91, pp. 1343-1346; Llach, J., Rimola, A., Navasa, M., Incidence and predictive factors of first episode of spontaneous bacterial peritonitis in cirrhosis with ascites: Relevance of ascitic fluid protein concentration (1992) Hepatology (Baltimore, Md), 16, pp. 724-727; Tito, L., Rimola, A., Gines, P., Recurrence of spontaneous bacterial peritonitis in cirrhosis: Frequency and predictive factors (1988) Hepatology (Baltimore, Md), 8, pp. 27-31; Runyon, B.A., Patients with deficient ascitic fluid opsonic activity are predisposed to spontaneous bacterial peritonitis (1988) Hepatology (Baltimore, Md), 8, pp. 632-635; Laffi, G., Carloni, V., Baldi, E., Impaired superoxide anion, platelet-activating factor, and leukotriene B4 synthesis by neutrophils in cirrhosis (1993) Gastroenterology, 105, pp. 170-177; Rimola, A., Soto, R., Bory, F., Reticuloendothelial system phagocytic activity in cirrhosis and its relation to bacterial infections and prognosis (1984) Hepatology (Baltimore, Md), 4, pp. 53-58
PY - 2016
Y1 - 2016
N2 - The incidence of Sjögren syndrome (SS) in primary biliary cirrhosis (PBC) patients is high. The influence of SS on the clinical outcomes of PBC patients, however, remains unclear. Our study retrospectively collected data on PBC-only patients and PBC patients with concomitant SS (PBC-SS) to compare the clinical differences of longterm outcomes between them. A total of 183 patients were diagnosed with PBC from January 1999 to December 2014 at our hospital. Of these, the authors excluded patients with diabetes, hypertension, advanced liver cirrhosis at initial diagnosis of PBC (Child-Turcotte-Pugh classification score of ≥7) and other liver diseases (ie, alcoholic liver disease, alpha-antitrypsin deficiency, viral hepatitis, and primary sclerosing cholangitis), and autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Of the remaining 125 patients, 77 (61.6%) were PBC-only and 48 (38.4%) were PBC-SS patients. The mean follow-up duration was 8.76 years. During the observation period, the incidence of interstitial lung disease was higher in the PBC-SS group than in the PBC-only group (P = 0.005). The occurrence of spontaneous bacterial peritonitis was significantly different in PBC-SS patients than in PBC-only patients (P = 0.002). The overall survival was lower in PBC-SS patients than in PBC-only patients (P = 0.033). Although the incidence of hepatocellular carcinoma, end-stage renal disease, variceal bleeding, and hypothyroidism were all higher in the PBC-SS group than in the PBC-only group, the differences were not significant. Our study suggests that PBC-SS patients have a higher risk of developing interstitial lung disease and spontaneous bacterial peritonitis and have a poor prognosis. Aggressive surveillance of thyroid and pulmonary functions should therefore be performed in these patients. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
AB - The incidence of Sjögren syndrome (SS) in primary biliary cirrhosis (PBC) patients is high. The influence of SS on the clinical outcomes of PBC patients, however, remains unclear. Our study retrospectively collected data on PBC-only patients and PBC patients with concomitant SS (PBC-SS) to compare the clinical differences of longterm outcomes between them. A total of 183 patients were diagnosed with PBC from January 1999 to December 2014 at our hospital. Of these, the authors excluded patients with diabetes, hypertension, advanced liver cirrhosis at initial diagnosis of PBC (Child-Turcotte-Pugh classification score of ≥7) and other liver diseases (ie, alcoholic liver disease, alpha-antitrypsin deficiency, viral hepatitis, and primary sclerosing cholangitis), and autoimmune diseases such as systemic lupus erythematosus and rheumatoid arthritis. Of the remaining 125 patients, 77 (61.6%) were PBC-only and 48 (38.4%) were PBC-SS patients. The mean follow-up duration was 8.76 years. During the observation period, the incidence of interstitial lung disease was higher in the PBC-SS group than in the PBC-only group (P = 0.005). The occurrence of spontaneous bacterial peritonitis was significantly different in PBC-SS patients than in PBC-only patients (P = 0.002). The overall survival was lower in PBC-SS patients than in PBC-only patients (P = 0.033). Although the incidence of hepatocellular carcinoma, end-stage renal disease, variceal bleeding, and hypothyroidism were all higher in the PBC-SS group than in the PBC-only group, the differences were not significant. Our study suggests that PBC-SS patients have a higher risk of developing interstitial lung disease and spontaneous bacterial peritonitis and have a poor prognosis. Aggressive surveillance of thyroid and pulmonary functions should therefore be performed in these patients. Copyright © 2016 Wolters Kluwer Health, Inc. All rights reserved.
U2 - 10.1097/MD.0000000000002537
DO - 10.1097/MD.0000000000002537
M3 - Article
SN - 0025-7974
VL - 95
JO - Medicine (United States)
JF - Medicine (United States)
IS - 2
ER -
SDG 3 Good Health and Well-being