알코올성 간염 환자에서 확인된 담즙세관항체 1
Case of Bile Canalicular Antibody in a Korean Patient with Alcoholic Hepatitis
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초록
담즙세관항체(Bile canalucular antibody, BCA)는 1969년에 처음 소개되었다. 1970년대와 80년대에 시행된 많은 연구들은 이 항체가 만성활동성간염과 원발성담즙성간경화 환자에서 높은 양성률을 보인다고 밝혔다. 이를 근거로 BCA가 여러 간질환의 진단에 유용할 것으로 주장하였다. 그러나, BCA는 알코올성간염 환자에서는 흔히 관찰되지 않는다. 저자들은 알코올성간염 환자에서 관찰된 한국에서의 BCA양성인 첫 사례를 보고하고자 한다. 환자는 주 3회, 소주 1병의 음주력이 있는 50세 여성으로 AST, ALT가 상승하여 음주력을 토대로 알코올성 간염으로 진단되었다. 면역학적 검사에서 AMA, ASMA, LKM antibody는 모두 음성을 보였으나, 검사를 시행하던 중 우연히 BCA가 1:160의 역가로 관찰되었다. 본 사례를 시작으로 앞으로 신중히 BCA를 검출하고자 하는 시도가 이뤄진다면, 더 많은 증례를 발견할 수 있는 계기가 되어 특정 질환군과의 연관성 등을 연구할 수 있을 것으로 기대할 수 있을 것이다.
Abstract
Bile canalicular antibody (BCA) was first reported in 1969. Many studies of BCA were performed in the 1970s and 1980s and revealed that BCA has a highly positive rate in chronic active hepatitis and primary biliary cirrhosis (PBC). These studies suggested that BCA can be useful in the diagnosis of these liver diseases. However, BCA is almost negative in patients with alcoholic hepatitis. We report a case of BCA in a 50-yr-old woman with a history of heavy alcohol consumption. The patient’s serum levels of aspartate transaminase and alanine transaminase were increased, leading to a diagnosis of alcoholic hepatitis. The patient was evaluated for liver disease. Anti-mitochondria antibody, anti-smooth muscle antibody, and anti-liver kidney microsomal antibody tests were conducted, yielding negative results. However, during this testing process, the patient’s serum was incidentally found to be positive for BCA at a titer of 1:160. This is the first case report of BCA in Korea.
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