원발성 담즙성 간경변증으로 진단되고 자가면역성 간염의 Feature를 보이는 한국인 환자에 대한 Simplified Scoring Criteria의 의미

Abstract

Background/Aims: The diagnosis of primary billiary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome remainschallenging. In 2008, a simplified scoring system was proposed by the International Autoimmune Hepatitis Group, which aimed forwider applicability in routine clinical practice. We evaluated the performance of the new simplified AIH scoring criteria as adiagnostic tool for overlap syndrome. Methods: We retrospectively reviewed the clinical histories, chemistry, autoimmune studies, and liver biopsy results of 25 patientsdiagnosed with PBC who visited Soonchunhyang University Hospital, Bucheon and Seoul, between November 2004 andDecember 2009. Parameters relevant to the revised and simplified scoring criteria were recorded, and outcomes were comparedbetween those with and without features of overlap syndrome. Results: Of 25 patients with a definite diagnosis of PBC, five (20%) were diagnosed with overlap syndrome using the revisedcriteria, and 18 patients (72%) were diagnosed with the simplified criteria. Those patients diagnosed according to the simplifiedscoring criteria revealed an increased frequency of anti-nuclear antibody (p= 0.030) and serum IgG levels (p= 0.092).Additionally, advanced fibrosis was significantly more frequent in patients with overlap syndrome (p= 0.017). Conclusions: The simplified scoring criteria seemed to be useful as a diagnostic tool to recognize overlap syndrome in Korea.However, a relatively small number of patients were included in our study, so further clinical trials based on larger populations