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Glomerulonephritis in primary biliary cholangitis in China: an important complication
Sainan Bian1,2,3, Li Wang1,2,3, Yunyun Fei1,2,3
1Department of Rheumatology and Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, No.1 Shuaifuyuan, Dongcheng District, Beijing, 100730, China.
Glomerulonephritis is a potential complication in primary biliary cholangitis (PBC) patients, with membranous nephropathy being the most common form. Routine screening for kidney disease in PBC patients is recommended.
Area of Science:
- Nephrology
- Hepatology
- Autoimmunology
Background:
- Extrahepatic manifestations are increasingly recognized in primary biliary cholangitis (PBC).
- Glomerulonephritis is a less commonly known complication of PBC.
Purpose of the Study:
- To investigate the clinicopathological features and prognosis of glomerulonephritis in PBC patients.
- To determine the prevalence and types of glomerulonephritis associated with PBC.
Main Methods:
- Retrospective analysis of 330 PBC patients from January 2002 to May 2019.
- Exclusion of PBC patients with other autoimmune diseases causing nephritis.
- Review and summarization of existing literature on PBC and glomerulonephritis.
Main Results:
- Glomerulonephritis was identified in 3.0% (10/330) of PBC patients.
- Membranous nephropathy (MN) was the most frequent type (4/10), followed by IgA nephropathy and minimal change disease.
- The study identified 10 cases of MN, 1 MCD, 1 IgA N, and 1 APSGN in PBC patients, compared to literature.
Conclusions:
- Glomerulonephritis is a significant, though not widely recognized, complication of PBC.
- Membranous nephropathy is the predominant form of glomerulonephritis in PBC.
- Screening for PBC in patients with MN is advised due to PBC's potential asymptomatic nature and risk of cirrhosis.
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