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Aim: To compare the respective clinical and pathologic features of antimitochondrial antibodies-negative (AMA-negative) primary biliary cirrhosis (PBC) and cholestatic type drug-induced liver injury (DILI) for clinical differential diagnosis.

Patients And Methods: Clinical data from 23 patients with AMA-negative PBC and 39 patients with cholestatic type DILI, treated at our hospital between January 2013 and January 2024, were collected and retrospectively analyzed.

Results: The cholestatic type DILI group exhibited a higher incidence of malaise and abdominal pain compared with the AMA-negative PBC group.

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Prediction of primary biliary cholangitis among health check-up population with anti-mitochondrial M2 antibody positive.

Clin Mol Hepatol

December 2024

Department of Clinical Laboratory, State key Laboratory of Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China.

Background: Anti-mitochondrial M2 antibody (AMA-M2) is a specific marker for primary biliary cholangitis (PBC) and it could be also presented in non-PBC individuals.

Methods: A total of 72173 Chinese health check-up individuals tested AMA-M2, of which non-PBC AMA-M2 positive individuals were performed follow-up. Baseline data of both clinical characteristics and laboratory examinations were collected in all AMA-M2-positive individuals.

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Primary biliary cholangitis: Personalizing second-line therapies.

Hepatology

November 2024

Department of Medicine, Division of Gastroenterology and Hepatology, University of California Davis School of Medicine, Sacramento, California, USA.

Article Synopsis
  • Primary biliary cholangitis (PBC) is an autoimmune disease primarily affecting middle-aged women, characterized by damage to small bile ducts, leading to liver issues like cholestasis and cirrhosis.
  • The main treatment for PBC has been ursodeoxycholic acid, which helps slow disease progression but doesn't alleviate symptoms; new second-line therapies are being developed for patients who don't respond well.
  • Recent medications like obeticholic acid, elafibranor, and seladelpar show promise in improving liver function and reducing cholestasis, while considerations for personalized treatment based on patient features are essential.
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Rationale: Anti-mitochondrial antibodies (AMA) M2-positive myositis can lead to severe respiratory failure. Traditional immunotherapies sometimes fail to address respiratory failure. Herein, this CARE-compliant case report described a patient with AMA-M2-positive myositis who recovered from ventilation with tracheostomy owing to immunotherapy-resistant respiratory failure to spontaneous breathing after modified lung volume recruitment (mLVR) therapy.

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Article Synopsis
  • * A new monoclonal chimeric IgG1 antibody, called 4G6, has been developed from a murine-specific antibody for the inner lipoyl domain of PDC-E2 and can recognize all AMA epitopes used in current diagnostic tests.
  • * The 4G6 antibody demonstrates strong binding affinity, making it a reliable quantitative reference for AMA testing and a promising standard for international use.
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