Colangitis biliar primaria y su asociación con otras enfermedades autoinmunes en una cohorte mexicana

Primary biliary cholangitis (PBC), previously known as primary biliary cirrhosis, is a chronic cholestatic autoimmune disease, secondary to biliary epithelial cell damage that causes destruction of the small and medium-caliber interlobular and septal bile ducts. The natural history of PBC is characterized by different phases. The first is the preclinical phase, in which there is only evidence of antimitochondrial antibodies (AMAs). The asymptomatic phase follows, with an elevated alkaline phosphatase level, which can then progress to a symptomatic phase, predominantly characterized by fatigue and pruritus. The last phase is the terminal phase, in which complications associated with the development of cirrhosis of the liver are present. The pathogenesis of PBC is not fully understood, but it is thought to be multifactorial. The participation of genetic, epigenetic, environmental, and even infectious factors appears to be necessary for its development. Therefore, the study of risk factors, as well as the association with other nonhepatic autoimmune diseases in different geographic areas, is most relevant. In the present study conducted by González-Huezo et al., 78 patients diagnosed with PBC at a tertiary care hospital in central Mexico were retrospectively evaluated. The authors previously excluded 36 patients due to incomplete clinical data or diagnosis of PBC-autoimmune hepatitis overlap syndrome. Similar to that reported in other case series, the prevalence of AMAs, antinuclear antibodies (ANAs), and anti-smooth muscle antibodies (ASMAs) was 95, 71, and