PMC4706410_01
The clinical course of the patient.
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He had been taking prednisone (6 mg/day) and salazosulfapyridine (1000 mg/day) for RA since 2012 (Fig. 1).
(A) A liver biopsy at day 4. Marked inflammatory cell infiltration is observed surrounding and destroying the interlobular bile ducts with ductular proliferation in the portal area. (B) A liver biopsy at day 445. The infiltration of inflammatory cells in the portal area is markedly improved.
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AMA-M2 antibodies, 34.1 (normal; <6); Anti-gp210 antibodies, 0.2 U/mL (normal; <6); Anti-centromere antibodies, 55.6 U/mL (normal; <9.9). A liver biopsy at day 4 showed marked inflammatory cell infiltration surrounding and destroying the interlobular bile ducts in the portal area (Fig. 2A). A second biopsy after 445 days of UDCA treatment showed marked improvement of inflammation in the portal area (Fig. 2B).