attack. In PBC, it is the microscopic intra-hepatic bile duct that is the immunologic target, whereas in PSC, both intra- and extra-hepatic bile ducts are involved and in AIH, the antigenic target is located on the hepatocyte. Aside from the fact that all three diseases will result in end-stage cirr...
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| Format: | Text |
| Language: | English |
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| Online Access: | http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.656.8804 http://www.wjgnet.com/1007-9327/12/3625.pdf |
| Summary: | attack. In PBC, it is the microscopic intra-hepatic bile duct that is the immunologic target, whereas in PSC, both intra- and extra-hepatic bile ducts are involved and in AIH, the antigenic target is located on the hepatocyte. Aside from the fact that all three diseases will result in end-stage cirrhosis, resulting in morbidity and premature mortality unless rescued by an increasingly scarce liver transplant, there are similarities between all these three liver diseases. Overlap syndrome, in which a patient may have features of both PBC and AIH[1] or PSC and AIH[2], is well recognized to occur and is often seen by clinicians. Occasionally, patients have been reported to have overlap with PBC and PSC as well as all three[3]. Furthermore, it is well recognized that patients with PBC and AIH can have many associated extra-hepatic autoimmune disease, especially rheumatologic conditions[4,5]. PSC, although classically occurring in the context of ulcerative colitis, is also reported to be associated with an increased likelihood of co-existent extra-intestinal, extra-hepatic autoimmune diseases compared to those with ulcerative colitis alone[6]. Recently, we have reported evidence that suggests that the Aboriginal population of British Columbia (BC), Canada (i.e. part of Canada’s First Nations) has a significant |
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