PRIMARY BILIARY-CIRRHOSIS ASSOCIATED WITH IDIOPATHIC THROMBOCYTOPENICPURPURA

A case of primary biliary cirrhosis (PBC) associated with idiopathic t hrombocytopenic purpura (ITP) is reported. The patient is a 59-year-ol d man. When he was 49 years old, he was diagnosed with ITP and receive d steroid therapy that successfully increased platelet numbers. Howeve r, the steroid therapy failed to normalize the elevated gamma-glutamyl transpeptidase. Ten years after this episode, he suffered from genera l itching and malaise and exhibited a gradual increase of serum biliar y enzyme levels. Immunologically, IgM was increased and anti-mitochond rial antibody was positive. Histological findings of liver needle biop sy showed chronic non-suppurative destructive cholangitis, confirming the diagnosis of PBC. To date, very few PBC cases associated with ITP have been reported. Our case is the second one in Japan. PBC and ITP i n our patient seemed to develop simultaneously, but the effect of ster oid therapy on the two conditions was different. This result suggests that the autoimmune process may have been different in PBC and ITP in the present patient.