vitamin-b-12 and Liver-Cirrhosis--Biliary

We investigated the prevalence of antibodies against gastric parietal cells (GPA), intrinsic factor antibodies (IFA) and the presence of pernicious anemia in a large cohort of primary biliary cirrhosis (PBC) patients as similar data is missing.. 157 PBC patients and 357 controls (73 with autoimmune hepatitis (AIH), 35 primary sclerosing cholangitis (PSC), 45 HBV, 37 HCV, 36 alcoholic liver disease (ALD), 35 non-alcoholic fatty liver disease (NAFLD) and 96 healthy) were investigated for IgG-isotype-specific GPA and IFA by ELISAs and vitamin-B(12) levels by a microparticle enzyme immunoassay.. The detection of IgG-GPA was significantly higher in PBC (31.8%) compared to AIH (10.9%; p=0.001), PSC (0%; p=0.000), HCV (13.5%; p=0.01), HBV (13.3%; p=0.006), ALD (8.3%; p=0.004), NAFLD (11.4%; p=0.003) and healthy (10.4%; p=0.001). IgG-IFA were detected in 12% of GPA-positive PBC patients and in none of the other liver diseases or in healthy (p=0.001). This reactivity was significantly associated with lower vitamin-B(12) levels compared to those with an IFA-negative test (p=0.025).. A significant proportion of PBC patients had IgG-GPA and IFA compared to controls. IgG-IFA were detected only in GPA-positive PBC patients and associated with lower vitamin-B(12) levels compared to those with an IFA-negative test.

Topics: Adult; Aged; Aged, 80 and over; Anemia, Pernicious; Autoantibodies; Biomarkers; Enzyme-Linked Immunosorbent Assay; Female; Greece; Humans; Intrinsic Factor; Liver Cirrhosis, Biliary; Middle Aged; Parietal Cells, Gastric; Sensitivity and Specificity; Vitamin B 12; Young Adult

To assess the hypercoagulability in PBC and its relationship with homocysteine (HCY) and various components of the haemostatic system.. We investigated 51 PBC patients (43F/8M; mean age: 63+/-13.9 yr) and 102 healthy subjects (86 women/16 men; 63+/-13 yr), and evaluated the haemostatic process in whole blood by the Sonoclot analysis and the platelet function by PFA-100 device. We then measured HCY (fasting and after methionine loading), tissue factor (TF), thrombin-antithrombin complexes (TAT), D-dimer (D-D), thrombomodulin (TM), folic acid, vitamin B6 and B12 plasma levels. C677T 5,10-methylenetetrahydrofolate reductase (MTHFR) polymorphism was analyzed.. Sonoclot RATE values of patients were significantly (P<0.001) higher than those of controls. Sonoclot time to peak values and PFA-100 closure times were comparable in patients and controls. TAT, TF and HCY levels, both in the fasting and post-methionine loading, were significantly (P<0.001) higher in patients than in controls. Vitamin deficiencies were detected in 45/51 patients (88.2%). The prevalence of the homozygous TT677 MTHFR genotype was significantly higher in patients (31.4%) than in controls (17.5%) (P<0.05). Sonoclot RATE values correlated significantly with HCY levels and TF.. In PBC, hyper-HCY is related to hypovitaminosis and genetic predisposing factors. Increased TF and HCY levels and signs of endothelial activation are associated with hypercoagulability and may have an important role in blood clotting activation.

Topics: Adult; Aged; Antithrombin III; Female; Folic Acid; Hemostasis; Homocysteine; Humans; Hyperhomocysteinemia; Liver Cirrhosis, Biliary; Male; Middle Aged; Peptide Hydrolases; Platelet Function Tests; Thrombomodulin; Thrombophilia; Thromboplastin; Vitamin B 12; Vitamin B 6

We experienced a female case with asymptomatic primary biliary cirrhosis that was associated with pernicious anemia after 16 years from the onset. She was 52 years old when she first visited a clinic in 1981 for liver dysfunction treatment. Antimitochondrial antibody was negative and antipyruvate dehydrogenase complex antibody was positive in a low titer in its immunoglobulin (Ig)M type. Histological examination of her liver revealed a presence of definite chronic non-suppurative destructive cholangitis with numerous epithelioid cell granuloma. She had been given 600 mg of the oral daily dose of ursodeoxycholic acid since 1992. Macrocytic anemia incidiously appeared in September 1999. An immunological examination detected negative antiparietal cell antibodies and positive anti-intrinsic factor antibodies. Her bone marrow smear showed numerous megaloblasts and serum vitamin B12 in her blood was low at 99 pg/mL. Severe reversed atrophic-type gastritis (type A gastritis) was demonstrated by the use of dye-endoscopy with Congo red. Her macrocytic anemia dramatically improved after intramuscular administration of vitamin B12. In conclusion, attention should be given to the association of pernicious anemia during the follow up of primary biliary cirrhosis.

Topics: Anemia, Pernicious; Autoantibodies; Biopsy; Cholagogues and Choleretics; Female; Gastritis, Atrophic; Humans; Liver Cirrhosis, Biliary; Middle Aged; Transaminases; Ursodeoxycholic Acid; Vitamin B 12; Vitamin B Complex

Topics: Adolescent; Adult; Ascites; Bed Rest; Bloodletting; Child; Child, Preschool; Cholestyramine Resin; Dietary Fats; Dietary Proteins; Diuretics; Energy Intake; Female; Hemochromatosis; Hepatic Encephalopathy; Hepatolenticular Degeneration; Humans; Lactulose; Liver Cirrhosis; Liver Cirrhosis, Biliary; Male; Middle Aged; Mineralocorticoid Receptor Antagonists; Penicillamine; Potassium; Vitamin B 12

Topics: Alcoholism; Anemia; Anemia, Hypochromic; Avitaminosis; Cholestyramine Resin; Common Bile Duct; Diet; Diet Therapy; Diuretics; Folic Acid; Folic Acid Deficiency; Gastrointestinal Hemorrhage; Humans; Hydrochlorothiazide; Ion Exchange Resins; Jaundice; Liver Cirrhosis; Liver Cirrhosis, Biliary; Postoperative Complications; Prothrombin Time; Vitamin B 12; Vitamin B Complex; Vitamin K