Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature

The association between primary biliary cirrhosis (PBC) and autoimmune hemolytic anemia (AIHA) is uncommon; only fourteen such case reports have been described. In this report, three patients who developed AIHA on the basis of PBC underwent successful therapy with corticosteroids and ursodeoxycholic...

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Main Authors: Yu Tian, Chi Wang, Jian-Xiang Liu, Hua-Hong Wang
Format: Article
Language:English
Published: Karger Publishers 2009-08-01
Series:Case Reports in Gastroenterology
Subjects:
Online Access:http://www.karger.com/Article/FullText/229189
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author Yu Tian
Chi Wang
Jian-Xiang Liu
Hua-Hong Wang
author_facet Yu Tian
Chi Wang
Jian-Xiang Liu
Hua-Hong Wang
author_sort Yu Tian
collection DOAJ
description The association between primary biliary cirrhosis (PBC) and autoimmune hemolytic anemia (AIHA) is uncommon; only fourteen such case reports have been described. In this report, three patients who developed AIHA on the basis of PBC underwent successful therapy with corticosteroids and ursodeoxycholic acid (UDCA). Patient 3 was more complicated, suffering from PBC, Evans syndrome, Sjögren syndrome and Klinefelter syndrome simultaneously. This has not previously been reported in the world literature. Review of all fifteen cases showed that there is a prominent occurrence sequence that AIHA might take place on the basis of PBC. With sufficient doses of corticosteroids or immunosuppressant therapy, besides hemolysis under effective control, liver function also improved. According to the criteria of secondary AIHA, we may call them PBC-related AIHA. Thus, patients with PBC with serum bilirubin levels rising suddenly should undergo screening for associated hemolysis. Recommended treatment for PBC-related AIHA includes sufficient doses of corticosteroids to control the hemolysis in the acute phase, and immunosuppressant or adequate dose of UDCA to maintain therapy. These case reports have been increasing in recent years, so further reserch is needed to illustrate the incidence and natural courses of these two organ-specific autoimmune diseases.
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spelling doaj.art-81dc0cde1a47423fa761c52d2d91e10e2022-12-22T03:16:05ZengKarger PublishersCase Reports in Gastroenterology1662-06312009-08-013224024710.1159/000229189229189Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the LiteratureYu TianChi WangJian-Xiang LiuHua-Hong WangThe association between primary biliary cirrhosis (PBC) and autoimmune hemolytic anemia (AIHA) is uncommon; only fourteen such case reports have been described. In this report, three patients who developed AIHA on the basis of PBC underwent successful therapy with corticosteroids and ursodeoxycholic acid (UDCA). Patient 3 was more complicated, suffering from PBC, Evans syndrome, Sjögren syndrome and Klinefelter syndrome simultaneously. This has not previously been reported in the world literature. Review of all fifteen cases showed that there is a prominent occurrence sequence that AIHA might take place on the basis of PBC. With sufficient doses of corticosteroids or immunosuppressant therapy, besides hemolysis under effective control, liver function also improved. According to the criteria of secondary AIHA, we may call them PBC-related AIHA. Thus, patients with PBC with serum bilirubin levels rising suddenly should undergo screening for associated hemolysis. Recommended treatment for PBC-related AIHA includes sufficient doses of corticosteroids to control the hemolysis in the acute phase, and immunosuppressant or adequate dose of UDCA to maintain therapy. These case reports have been increasing in recent years, so further reserch is needed to illustrate the incidence and natural courses of these two organ-specific autoimmune diseases.http://www.karger.com/Article/FullText/229189Primary biliary cirrhosisAutoimmune hemolytic anemiaDrug therapy
spellingShingle Yu Tian
Chi Wang
Jian-Xiang Liu
Hua-Hong Wang
Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature
Case Reports in Gastroenterology
Primary biliary cirrhosis
Autoimmune hemolytic anemia
Drug therapy
title Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature
title_full Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature
title_fullStr Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature
title_full_unstemmed Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature
title_short Primary Biliary Cirrhosis-Related Autoimmune Hemolytic Anemia: Three Case Reports and Review of the Literature
title_sort primary biliary cirrhosis related autoimmune hemolytic anemia three case reports and review of the literature
topic Primary biliary cirrhosis
Autoimmune hemolytic anemia
Drug therapy
url http://www.karger.com/Article/FullText/229189
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