Clinical Picture of Recurrent Primary Biliary Cholangitis After Liver Transplantation
No Thumbnail Available
Date
2021
Authors
Journal Title
Journal ISSN
Volume Title
Publisher
Rīgas Stradiņa universitāte
Rīga Stradiņš University
Rīga Stradiņš University
Abstract
Studenta pētnieciskā darba nosaukums: Atkārtota primārā biliārā holangīta klīniskā aina pēc aknu transplantācijas.
Aktualitāte: Primāram biliāram holangītam raksturīgs hronisks autoimūns žultsvadu iekaisums, kas skar galvenokārt sievietes. Neraugoties uz plašiem šīs slimības pētījumiem, ārstēšanas metodes joprojām ir ļoti ierobežotas. Kā galvenā terapijas metode slimības beigu stadijā ir aknu transplantācija. Lai gan lielākajai daļai pacientu slimība ir asimptomātiska, daudziem pacientiem ir tādi dzīves kvalitāti ietekmējoši simptomi kā nogurums, izteikta nieze un galu galā slimība var progresēt, veidojot aknu cirozes klīnisko ainu. Pat pēc ortotopiskas aknu transplantācijas pastāv iespēja, ka slimība atgriezīsies, un definē kā "atkārtotu primāro holangītu". Diagnozi apstiprina ar biopsiju, kuras histoloģiskās pazīmes ir tādas pašas kā dzimtajās aknās. Ir veikti vairāki pētījumi par atkārtotu primāro biliāro holangītu. Tajos uzmanība galvenokārt tika pievērsta histoloģiskajiem kritērijiem. Tomēr par slimības recidīva simptomiem nav daudz runāts.
Pētījuma mērķis: Šī pētījuma mērķis ir noskaidrot konstitucionālos simptomus recidivējoša primārā biliārā holangīta gadījumā.
Pētījuma plāns: Tika veikts literatūras apskats, apkopojot rakstus no PubMed, EBSCO, NEJM, Cochrane Library un Journal of Gastroenterology. Raksti tika rūpīgi atlasīti, ņemot vērā pētījumu kvalitāti un piemērotību attiecībā uz darbā izvirzītajiem uzdevumiem. Lai izprastu primārā biliārā holangīta galvenos simptomus, rakstā iekļauts arī plašs literatūras apskats, kurā aprakstītas galvenās slimības pazīmes un simptomi, kā arī ar to saistītās slimības.
Pētījuma rezultāti: Visbiežāk sastopamais simptoms pacientiem ar atkārtotu primāro biliāro holangītu bija nieze, nogurums un dzelte. Dažos pētījumos tika ziņots arī par aknu slimību beigu stadijas simptomiem kā ascīts, aknu encefalopātiju un asiņošanu no varikozām vēnām. Atsevišķos pētījumos pacientiem ar slimības recidīvu simptomu nebija. Tomēr dažos pētījumos simptomi nebija norādīti.
Secinājums: Pacientiem ar recidivējošu primāro biliāro holangītu ir iespējams novērot simptomus, kādi bija novērojami pirms aknu transplantācijas.
Title of the student research work: Clinical Picture of Recurrent Primary Biliary Cholangitis after Liver transplantation. Topicality: Primary biliary cholangitis is characterized by a chronic autoimmune inflammation of the bile ducts, affecting primarily women. Despite extensive research of the disease, treatment modalities are still very limited. Apart from liver transplantation, therapeutic options are not curative. Whilst most are asymptomatic, a lot of patients have life-impacting fatigue, severe pruritus, and eventually the disease may progress to form a liver-cirrhosis based clinical picture. Even after orthotopic liver transplantation, there is a chance that the disease will return, now being defined as “recurrent primary cholangitis”. The diagnosis is confirmed by biopsy, with histological features present as they were in the native liver. Several studies have been made about recurrent primary biliary cholangitis. Their focus was mainly set on histological criteria. However, there is not much discussion about the symptoms of disease-relapse. Aim of the research: The aim of this study is to find any constitutional symptoms of Recurrent Primary Biliary Cholangitis. Research design: A literature review was made, with articles collected from PubMed, EBSCO, NEJM, Cochrane Library and the Journal of Gastroenterology. Articles were carefully selected according to their quality of the study and their suitability concerning the main questions of this research. In order to comprehend the main symptoms of primary biliary cholangitis, this research also includes a large review of the literature describing the main signs and symptoms of the disease, as well as its associated conditions. Research Results: Symptoms, as they were reported initially, were able to be found in several retrospective analyses. The most common symptom of patients with recurrent primary biliary cholangitis was pruritus, followed by fatigue, jaundice has also occurred. In some studies, also symptoms of end-stage liver diseases were reported. These included ascites, hepatic encephalopathy and variceal bleeding, with the latter even resulting in the death of one patient. There were also studies which stated that their observed patients with disease relapse were asymptomatic, and studies which did not mention the presence of any symptoms at all. Conclusion: Patients with recurrent primary biliary cholangitis have a chance to experience the symptoms that also characterize the disease before liver transplantation.
Title of the student research work: Clinical Picture of Recurrent Primary Biliary Cholangitis after Liver transplantation. Topicality: Primary biliary cholangitis is characterized by a chronic autoimmune inflammation of the bile ducts, affecting primarily women. Despite extensive research of the disease, treatment modalities are still very limited. Apart from liver transplantation, therapeutic options are not curative. Whilst most are asymptomatic, a lot of patients have life-impacting fatigue, severe pruritus, and eventually the disease may progress to form a liver-cirrhosis based clinical picture. Even after orthotopic liver transplantation, there is a chance that the disease will return, now being defined as “recurrent primary cholangitis”. The diagnosis is confirmed by biopsy, with histological features present as they were in the native liver. Several studies have been made about recurrent primary biliary cholangitis. Their focus was mainly set on histological criteria. However, there is not much discussion about the symptoms of disease-relapse. Aim of the research: The aim of this study is to find any constitutional symptoms of Recurrent Primary Biliary Cholangitis. Research design: A literature review was made, with articles collected from PubMed, EBSCO, NEJM, Cochrane Library and the Journal of Gastroenterology. Articles were carefully selected according to their quality of the study and their suitability concerning the main questions of this research. In order to comprehend the main symptoms of primary biliary cholangitis, this research also includes a large review of the literature describing the main signs and symptoms of the disease, as well as its associated conditions. Research Results: Symptoms, as they were reported initially, were able to be found in several retrospective analyses. The most common symptom of patients with recurrent primary biliary cholangitis was pruritus, followed by fatigue, jaundice has also occurred. In some studies, also symptoms of end-stage liver diseases were reported. These included ascites, hepatic encephalopathy and variceal bleeding, with the latter even resulting in the death of one patient. There were also studies which stated that their observed patients with disease relapse were asymptomatic, and studies which did not mention the presence of any symptoms at all. Conclusion: Patients with recurrent primary biliary cholangitis have a chance to experience the symptoms that also characterize the disease before liver transplantation.
Description
Medicīna
Medicine
Veselības aprūpe
Health Care
Medicine
Veselības aprūpe
Health Care
Keywords
Primārā biliārā ciroze, primārais biliārais holangīts, recidivējošs primārais biliārais holangīts, ortotopiskā aknu transplantācija, klīniskā aina., Primary Biliary Cirrhosis, Primary Biliary Cholangitis, Recurrent Primary Biliary Cholangitis, Orthotopic liver transplant, Clinical Picture