TY - JOUR
T1 - Seropositividad para Chlamydia pneumoniae en pacientes con cirrosis biliar primaria
AU - Montaño-Loza, A.
AU - Vázquez-Ballesteros, E.
AU - Meza-Junco, J.
AU - Villalobos-Zapata, I.
AU - Olivera-Martínez, M.
N1 - Funding Information:
Se incluyó en el estudio a 46 pacientes con diagnóstico de CBP (grupo en estudio) y se compararon con 105 pacientes sin cirrosis hepática (grupo control). El diagnóstico de CBP se realizó por la presencia de cuadro clínico característico2 y AMA positivos en 22 pacientes (48%) y por biopsia hepática con diagnóstico histológico definitivo en 24 (52%). De los 24 pacientes con biopsia hepática, 4 se encontraban en estadio I (inflamación de tractos portales alrededor de los conductos biliares), 3 en estadio II (destrucción y proliferación de conductos biliares con áreas de necrosis), 5 en estadio III (fibrosis extensa de tractos portales) y 12 en estadio IV (estadio septal, nódulos de regeneración rodeados de fibrosis)28. El tiempo promedio (± desviación estándar) transcurrido desde el diagnóstico de la enfermedad hasta la realización de la prueba de anti-cuerpos contra C. pneumoniae fue de 2,7 ± 2,2 años. El grupo control lo formaron pacientes consecutivos que acudieron a la consulta de medicina interna de nuestro instituto (51 con hipertensión arterial sistémica, 44 con diabetes mellitus, 6 con enfermedad tiroidea y 4 con obesidad). Previo consentimiento informado, y con la aprobación del Comité de Éti-ca del Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubi-rán, a todos los pacientes y controles se les extrajeron 10 ml de sangre para la búsqueda de anticuerpos antiinmunoglobulina (Ig) G contra C. pneumoniae por técnica de inmunofluorescencia (enzimoinmunoanálisis). Los anticuerpos IgG se detectaron de forma cualitativa y semicuantitativa, con una sensibilidad del 93% y una especificidad del 86,2% (enzimoin-
PY - 2006/3
Y1 - 2006/3
N2 - INTRODUCTION: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory injury and bile duct destruction. Recent studies suggest that Chlamydia pneumoniae could be associated with the development of PBC. The aim of this study was to determine the seroprevalence of C. pneumoniae in a cohort of patients with PBC. PATIENTS AND METHODS: The presence of IgG antibodies against C. pneumoniae was investigated in 46 patients with PBC and in 105 subjects without cirrhosis. RESULTS: Twenty-one patients (46%) with PBC had antibodies against C. pneumoniae compared with 74 subjects (71%) in the control group (OR = 0.6; 95% CI, 0.3-1.2; p = NS). Subanalysis of the PBC group showed that patients with C. pneumoniae antibodies had a higher frequency of advanced Child-Pugh stages (24% A, 52% B and 24% C vs 64% A, 32% B and 4% C; p = 0.01), a higher score on the Mayo Clinic Prognostic Index (7.8 ± 2.1 vs 5.6 ± 1.2; p = 0.004), a higher frequency of ascites (29% vs 4%; OR = 9.6; 95% CI, 1-87; p = 0.02), higher total bilirubin levels (4.5 ± 2.5 mg/dl vs 2.4 ± 4.3 mg/dl, p = 0.001) and lower serum albumin levels (2.6 ± 0.9 g/dl vs 3.3 ± 0.6 g/dl, p = 0.02). CONCLUSION: No association was found between C. pneumoniae infection and PBC in this study. An association was found between the severity of PBC and C. pneumoniae, which may suggest a deleterious effect of C. pneumoniae infection or a predisposition in advanced stages of PBC to acquire infection with this microorganism.
AB - INTRODUCTION: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease characterized by inflammatory injury and bile duct destruction. Recent studies suggest that Chlamydia pneumoniae could be associated with the development of PBC. The aim of this study was to determine the seroprevalence of C. pneumoniae in a cohort of patients with PBC. PATIENTS AND METHODS: The presence of IgG antibodies against C. pneumoniae was investigated in 46 patients with PBC and in 105 subjects without cirrhosis. RESULTS: Twenty-one patients (46%) with PBC had antibodies against C. pneumoniae compared with 74 subjects (71%) in the control group (OR = 0.6; 95% CI, 0.3-1.2; p = NS). Subanalysis of the PBC group showed that patients with C. pneumoniae antibodies had a higher frequency of advanced Child-Pugh stages (24% A, 52% B and 24% C vs 64% A, 32% B and 4% C; p = 0.01), a higher score on the Mayo Clinic Prognostic Index (7.8 ± 2.1 vs 5.6 ± 1.2; p = 0.004), a higher frequency of ascites (29% vs 4%; OR = 9.6; 95% CI, 1-87; p = 0.02), higher total bilirubin levels (4.5 ± 2.5 mg/dl vs 2.4 ± 4.3 mg/dl, p = 0.001) and lower serum albumin levels (2.6 ± 0.9 g/dl vs 3.3 ± 0.6 g/dl, p = 0.02). CONCLUSION: No association was found between C. pneumoniae infection and PBC in this study. An association was found between the severity of PBC and C. pneumoniae, which may suggest a deleterious effect of C. pneumoniae infection or a predisposition in advanced stages of PBC to acquire infection with this microorganism.
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U2 - 10.1157/13085138
DO - 10.1157/13085138
M3 - Article
C2 - 16507276
AN - SCOPUS:33645367545
SN - 0210-5705
VL - 29
SP - 113
EP - 116
JO - Gastroenterologia y Hepatologia
JF - Gastroenterologia y Hepatologia
IS - 3
ER -