Primarna bilijarna ciroza i sarkoidoza jetre

  • Tamara Alempijević Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Aleksandra Sokic-Milutinović Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Ljubiša Tončev Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia
  • Aleksandra Pavlović-Marković Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Srdjan Djuranovic Clinic for Gastroenterology and Hepatology, Clinical Center of Serbia, Belgrade, Serbia; Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Nada Tomanović Faculty of Medicine, University of Belgrade, Belgrade, Serbia
  • Jelena Drulović Faculty of Medicine, University of Belgrade, Belgrade, Serbia; Clinic for Neurology, Clinical Center of Serbia, Belgrade, Serbia
DOI: https://doi.org/10.2298/2116
Ključne reči: liver cirrhosis, biliary||, ||jetra, bilijarna ciroza, sarcoidosis||, ||sarkoidoza, diagnosis, differential||, ||dijagnoza, diferencijalna, histological techniques||, ||histološke tehnike, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Primarna bilijarna ciroza (PBC) je imunološka, hronična, progresivna bolest jetre koja dovodi do destrukcije malih, interlobularnih žučnih kanala. Sarkoidoza je hronična bolest nepoznate etiologije koju karakterišu nekazeozni granulomi. Prikaz bolesnika. Prikazana je bolesnica stara 69 godina, sa bolom u trbuhu, malaksalošću, vrtoglavicom, glavoboljom, tremorom i delimičnim gubitkom sluha. Laboratorijske analize ukazale su na povišene vrednosti enzima jetre, holesterola i pozitivna antimitohondrijalna i antinuklearna antitela. Biopsijom jetre dokazani su granulomi tipični za PBC i granulomske lezije karakteristične za sarkoidozu. Nalaz povišenih vrednosti angiotenzin-konvertujućeg enzima i granuloma na magnetnoj rezonanci endokranijuma doveli su do dijagnoze PBC i sarkoidoze jetre uz neurosarkoidozu. Bolesnica je lečena ursodeoksiholnom kiselinom (UDCA) i prednizolonom. Nakon šest meseci praćenja bolesnica je bila bez simptoma uz normalne vrednosti laboratorijskih analiza. Zaključak. Kod bolesnika sa PBC potrebno je razmotriti postojanje drugih granulomskih bolesti jetre ukoliko poremećaj hepatograma perzistira nakon uvođenja UDCA u terapiju.

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Objavljeno
2015/04/21
Broj časopisa
Vol. 71 Br. 1 (2014)
Rubrika
Prikaz bolesnika