Original Article
Clinical characteristics of patients with autoimmune liver disease complicated with gallbladder stone
Liu Man, Zheng Zhongqing, Zhou Simin, Zhang Hongxia, Chu Hongyu, Wang Xiaoyi, Zhang Jie, Zhou Lu, Wang Bangmao
Published 2020-02-15
Cite as Chin J Dig, 2020, 40(2): 105-109. DOI: 10.3760/cma.j.issn.0254-1432.2020.02.008
Abstract
ObjectiveTo explore the clinical characteristics of liver function of patients with autoimmune liver disease (AILD) complicated with gallbladder stone (GS), so as to guide clinical practice.
MethodsFrom November 2009 to October 2018, at General Hospital of Tianjin Medical University, the clinical data of 386 patients with AILD were retrospectively analyzed. According to the relevant diagnostic criteria, 208 cases of autoimmune hepatitis (AIH), 129 cases of primary biliary cholangitis (PBC) and 49 cases of PBC-AIH overlap syndrome were screened out. The incidence, clinical characteristics and the changes of laboratory indicators including albumin, alkaline phosphatase (ALP) and γ-glutamyl transferase (GGT) of AILD patients complicated with GS were analyzed. Chi-square test, t test and rank sum test were performed for statistical analysis.
ResultsThere was no significant difference in the incidence between AILD, AIH, PBC and PBC-AIH overlap syndrome patients complicated with GS (32.9%, 127/386; 28.8%, 60/208; 36.4%, 47/129 and 40.8%, 20/49; respectively; P>0.05). Gallstones of AILD patients complicated with GS mostly were multiple and small stones with maximum diameter <1 cm (45.7%, 58/127 and 57.7%, 60/104, respectively). The age of initial diagnosis, the proportion of liver cirrhosis at inital diagnosis and the levels of ALP and GGT were higher in AILD patients complicated with GS than those of AILD patients without GS ((60.5±11.5) years vs. (57.6±11.5) years; 53.5%, 68/127 vs. 42.1%, 109/259; 154.00 U/L (89.00 U/L, 257.00 U/L) vs. 125.00 U/L (86.00 U/L, 212.00 U/L); 169.00 U/L (79.00 U/L, 343.00 U/L) vs. 128.60 U/L (48.00 U/L, 284.00 U/L); respectively); however the albumin level was lower than that of AILD patients without GS ((36.46±7.30) g/L vs. (38.34±7.58) g/L), and the differences were statistically significant (t=-2.361, χ2=4.506, Z=-2.192, -2.443, t=2.322; all P<0.05). The incidence of GS in AILD patients≥60 years old was higher than that AILD patients<60 years old (37.6%, 73/194 vs. 28.1%, 54/192), and the difference was statistically significant (χ2=3.948, P=0.047). The incidence of GS in AILD patients and AIH patients complicated with liver cirrhosis was higher than that in patients without liver cirrhosis (38.4%, 68/177 vs. 28.2%, 59/209; 35.7%, 35/98 vs. 22.7%, 25/110; respectively), and the differences were statistically significant (χ2=4.506 and 4.259, P=0.034 and 0.039).
ConclusionsAILD patients complicated with GS are common, most are multiple and small stones. When complicated with GS, the initial diagnosis may be delayed and the rate of liver cirrhosis at initial diagnosis may increase. The incidence of GS is high in AILD patients with older age and liver cirrhosis.
Key words:
Liver cirrhosis; Autoimmune liver disease; Gallbladder stone; Liver function; Age
Contributor Information
Liu Man
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Zheng Zhongqing
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Zhou Simin
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Zhang Hongxia
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Chu Hongyu
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Wang Xiaoyi
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Zhang Jie
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Zhou Lu
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China
Wang Bangmao
Department of Gastroenterology and Hepatology, General Hospital of Tianjin Medical University, Tianjin 300052, China