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Improvement of primary biliary cholangitis (PBC) under treatment with sulfasalazine and abatacept
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  1. Florian Popp1,
  2. David Semela2,
  3. Johannes von Kempis1,
  4. Ruediger B Mueller1
  1. 1Division of Rheumatology, Immunology and Rehabilitation, Kantonsspital Sankt Gallen, Sankt Gallen, Switzerland
  2. 2Division of Gastroenterology and Hepatology, Kantonsspital Sankt Gallen, Sankt Gallen, Switzerland
  1. Correspondence to Dr Florian Popp, florian.popp{at}kssg.ch

https://doi.org/10.1136/bcr-2018-224205

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    Description

    A 51-year-old female patient was diagnosed with primary biliary cholangitis (PBC) in 2012 and rheumafactor-positive, Anti-citrullinated protein antibodies (ACPA)-positive rheumatoid arthritis (RA) in 2013. The diagnosis of a PBC was confirmed by liver biopsy showing portal inflammatory infiltrates with non-suppurative inflammatory lesions of the biliary duct (figure 1). PBC has been treated with ursodeoxycholic acid since 2012.

    Figure 1

    Dense lymphocytic infiltrates in portal tracts affecting small portal bile ducts, moderate lobular infiltrates.

    After diagnosis of RA (initial Disease Activity Score 28 (DAS 28)=6.43), therapy was initiated with leflunomide 20 mg/day and low-dose oral glucocorticoids, tapered from 20 mg/day to zero over 12 weeks. Remission was reached within 4 months (DAS 28=1.84). However, elevated …

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