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ORIGINAL ARTICLES  
CMH 2012 December;18:375-382.
Published online 2012 December 24. doi:http://dx.doi.org/10.3350/cmh.2012.18.4.375
Copyright © 2012 The Korean Association for the Study of the Liver
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Prognostic indicators in primary biliary cirrhosis: significance of revised IAHG (International Autoimmune Hepatitis Group) score
Ho Eun Jung, Jae Young Jang, Soung Won Jeong, Jin Nyoung Kim, Hee Yoon Jang, Yun Ju Cho, Sung Ae Woo, Sae Hwan Lee, Sang Gyune Kim, Sang-Woo Cha, Young Seok Kim, Young Deok Cho, Hong Soo Kim, and Boo Sung Kim
Institute for Digestive Research, Digestive Disease Center, Department of Internal Medicine, Soonchunhyang University College of
Medicine, Seoul, Korea
Corresponding Author: Jae Young Jang ,Tel: +82-2-709-9863, Fax: +82-2-709-9797, Email: jyjang@schmc.ac.kr
ABSTRACT
Background/Aims: Primary biliary cirrhosis (PBC) is a slowly progressing autoimmune disease of the liver that is characterized by portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Serum total bilirubin is one of the various prognostic factors that have been proposed. A recent study found that PBC with accompanying autoimmune hepatitis (AIH) carries a negative prognosis. This study examined the clinical characteristics of PBC and analyzed the factors that affect its prognosis.
Methods: Patients diagnosed with PBC between January 1998 and December 2010 based on clinical and histopathological findings were compiled and analyzed retrospectively.
Results: Among 27 patients, 24 (1 male and 23 females, ages 50.0¡¾9.3 years) were followed up. The follow-up period was 8.6¡¾0.9 years. Of the 24 patients, 9 patients progressed to liver cirrhosis (LC). Comparison between patients who did and did not progress to LC revealed statistically significant differences in the patients¡¯ serum total bilirubin (2.7¡¾1.8 vs. 0.8¡¾0.4, P =0.012), the Mayo risk score (5.1¡¾0.7 vs. 3.9¡¾0.6, P =0.001), the revised IAHG (International Autoimmune Hepatitis Group) score (9.2¡¾2.3 vs. 5.4¡¾3.0, P=0.004) and frequency of AIH overlap (5/9 [55.6%] vs. 0/15 [0%], P=0.001) at the time of diagnosis.
Conclusions: We propose that serum total bilirubin, the Mayo risk score, and the revised IAHG score at the time of diagnosis are helpful for predicting PBC prognosis. In particular, since all of the patients with accompanying AIH progressed to LC, the presence of overlap syndrome at the time of diagnosis is helpful for predicting PBC prognosis and providing an adequate treatment.
Keywords: Primary biliary cirrhosis; Prognosis; Overlap syndrome
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