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Biomedical subjects

S J Hwang

Publications and source records attributed to S J Hwang.

At least 127 records · Page 7Linked to original sources
PubMed1996

Prognostic factor analysis of fulminant and subfulminant hepatic failure in an area endemic for hepatitis B.

In order to determine the criteria in selecting candidates for orthotopic liver transplantation (OLT), we assessed the aetiology and prognostic indicators in 61 patients with fulminant or subfulminant hepatitis during the past 13 years. Several previously reported models of high risk predictors were not suitable for a large portion of our patients with different aetiological and ethnic backgrounds. In the present study, serological markers of various hepatitis viruses were tested and clinical parameters were compared between survivors and non-survivors. Multiple virus infection and multifactorial causes were important in the pathogenesis (48%) of acute liver failure. Among the 13 clinical parameters, six were considered significant on univariate analysis: prothrombin time prolongation (P < 0.001), total bilirubin, creatinine and alpha-fetoprotein (P < 0.01), age and cholesterol (P < 0.05). With stepwise logistic regression using most discriminatory cut-off values, an age of > 43 years (P = 0.0001), total bilirubin levels of > 23 mg/dL (P < 0.005) and prothrombin time prolongation > 19 s (P < 0.0001) were independent predictors of non-survival. When applied to determine the index of poor prognosis, the sensitivity, specificity, positive predictive value, negative predictive value and predictive accuracy were 100, 67, 95, 100 and 95%, respectively, in the presence of any one of these prognostic factors. We conclude that these indicators may be useful for selecting patients with acute liver failure indicated for OLT.

Adolescent↗
PubMed1996

Evaluation of hepatitis B and C viral markers: clinical significance in Asian and Caucasian patients with hepatocellular carcinoma in the United States of America.

In order to evaluate the roles of hepatitis B virus (HBV) and hepatitis C virus (HCV) and their clinical significance in Asian-American and Caucasian patients with hepatocellular carcinoma (HCC) in the USA, 110 HCC patients, seen in a community-based teaching hospital in the Los Angeles area over a 10 year period, were enrolled. Seventy-nine (72%) patients were Asian-American and 31 (28%) were Caucasians. Of the 110 HCC patients, 69 (63%) were positive for serum hepatitis B surface antigen (HBsAg), 26 (24%) were positive for serum antibody to hepatitis C virus (anti-HCV), five (all Asian-Americans) were positive for both markers; 11 (10%) patients had a history of alcoholism. HBsAg was detected in 63 (80%) Asian-American patients, significantly higher than in the six (19%) Caucasian HCC patients (P < 0.01). Anti-HCV was detected in 10 (32%) Caucasian and in 16 (20%) Asian-American HCC patients (P > 0.05). Among Asian-American HCC patients, anti-HCV was more prevalent in those who were HBsAg-negative than in the HBsAg-positive patients (69 vs 8%; P < 0.01). A history of alcoholism was obtained in nine (29%) Caucasian HCC patients, significantly higher than in the two (3%) Asian-American HCC patients (P < 0.05). Comparing HCC patients with positive HBsAg and with anti-HCV, HBsAg-positive HCC patients were younger, Asian-Americans and predominantly male; 38% had a family history of liver disease. In contrast, anti-HCV-positive HCC patients were older by nearly a decade and 46% had a history of blood transfusion. Using a stepwise logistic regression analysis, Asian race and patient age < 50 years were found to be independent predictors for HBsAg-positivity, while a history of blood transfusion was the only predictor for anti-HCV-positivity in HCC patients. There was no significant difference in the rate of cirrhosis, serum levels of alpha-fetoprotein and survival between HBsAg-positive and anti-HCV-positive HCC patients. In conclusion, chronic HBV infection was the major aetiological factor in Asian-American HCC patients, while chronic HCV infection and alcoholism were major aetiological factors in Caucasian HCC patients in the USA.

Age Factors↗
PubMed1996

Risk factor analysis of patients with chronic hepatitis C in Taiwan.

BACKGROUND: Parenteral transmission is the major route for hepatitis C virus (HCV) infection. However, in western countries, 40% of patients with chronic hepatitis C have no apparent risk factor of HCV infection. This study was designed to investigate the possible risk factors of HCV transmission in chronic hepatitis C patients in Taiwan. METHODS: One hundred and sixty-one consecutive patients with chronic hepatitis C and 161 age- and sex-matched healthy subjects were enrolled. Risk factors, including blood transfusion, injection with nondisposable needles, education status, surgery, dental procedure, tattooing, ear-piercing, sexual behavior and alcoholism, were obtained in every patient through questionnairing and interviewing. RESULTS: Patients with chronic hepatitis C, compared with healthy controls, had significantly higher rates of previous history of blood transfusion, frequent nondisposable needle injections, and lower education status (43.5% vs. 10.6%, 19.9% vs. 6.2%, 42.2% vs. 23.0%, respectively, all p < 0.05). Univariate logistic regression analysis showed blood transfusion, frequent nondisposable needle injections and low education as significant risk factors of HCV infection (all p < 0.05). Multivariate analysis again revealed them all to be independent significant risk factors associated with HCV infection in chronic hepatitis C patients. CONCLUSIONS: Parenteral transmission of HCV via transfusion and frequent nondisposable needle injections were the main routes of contracting HCV infection in patients with chronic hepatitis C in Taiwan. Also, people with low education ran the higher risk of transmission by HCV. Meticulous screening of the transfused blood for HCV, usage of disposable needles, and mass public education are important in our efforts to decrease chronic HCV infection in Taiwan.

Adolescent↗
PubMed1996

Prenatal and postnatal changes of the human tonsillar crypt epithelium.

The tonsillar crypt shows infiltration of lymphoid cells in the epithelium and the highly porous or discontinuous basement membrane. However, the relationship between developmental period and the significance of the disrupted epithelial basement membrane and infiltration of lymphoid cells within the human tonsillar crypt epithelium is still obscure. The present study was designed to determine the prenatal and postnatal changes of the human tonsillar crypt epithelium in 4 fetuses, 4 neonates, 1 infant, 5 children and 4 adults using immunohistochemical stains with polyclonal anti-laminin and monoclonal anti-type IV collagen antibody, and transmission electron microscope. The tonsillar crypt epithelium from all fetuses and neonates showed infiltration of many lymphoid cells and an intact basement membrane by immunohistochemistry. Transmission electron microscope revealed pores in the basement membrane through which lymphocytes passed. Tonsils from a 4-month-old infant showed focal disruption of the basement membrane by immunohistochemical staining. The tonsils from children and adults showed that there was massive disruption of the basement membrane with lymphoid cell infiltration in the tonsillar crypt epithelium by immunohistochemical staining and transmission electron microscopy. In conclusion, lymphoid cell infiltration and holes of the basement membrane of the tonsillar crypt epithelium are normal developmental findings, whereas disruption of the basement membrane of the tonsillar crypt epithelium is pathological.

Adolescent↗
PubMed1996

[Removal of femoral interlocking nail-induced pulmonary embolism under spinal anesthesia--a case report].

Most of the lower limb surgeries are done under spinal anesthesia. This 21 year-old male had undergone open reduction with interlocking nail for his right femoral fracture and was scheduled for removal of interlocking nail. Spinal anesthesia was performed and a sensory block up to T8 level was achieved. During removing of the nail, the patient complained of chest pain, dyspnea and headache. Consequently, tachycardia and hypotension were observed. Then he coughed up pink frothy sputum. Ephedrine 5 mg was given to raise his blood pressure. About 3 min later, he recovered from the hypotension. Arterial blood gas analysis showed hypoxemia and hypercapnia. After endotracheal intubation, he was sent to surgical intensive care unit. In surgical intensive care unit, fat globules in urine, anemia and thrombocytopenia were noted. Chest roentgenogram showed patchy pulmonary infiltrates in the left lower lobe. A pulmonary artery catheter was inserted for pulmonary measurement, which read pulmonary artery pressure 45/28 mmHg, wedge pressure 14 mmHg, and cardiac output was 5-34 L/min. Supportive treatment which included steroid therapy, and O2 therapy with positive end-expiratory pressure was initiated under the impression of pulmonary embolism. The course in surgical ICU was uneventful and he left there three days later and was discharged on the fifth hospitalization day.

Adult↗
PubMed1995

Association study of transforming growth factor alpha (TGF alpha) TaqI polymorphism and oral clefts: indication of gene-environment interaction in a population-based sample of infants with birth defects.

In this study of infants with isolated birth defects, 69 cleft palate only cases, 114 cleft lip with or without cleft palate cases, and 284 controls with noncleft birth defects (all born in Maryland between 1984 and 1992) were examined to test for associations among maternal exposures, genetic markers, and oral clefts. A significantly higher frequency of positive family history of birth defects among both groups of oral cleft cases compared with controls was seen in these data. While there was a modest increase in the less common C2 allele at the TaqI site in the transforming growth factor alpha (TGF alpha) locus among cleft palate only infants compared with the birth defect controls, the association appeared to reflect an underlying interaction between maternal smoking and infant genotype. This apparent gene-environment interaction was also found among those reporting no family history of any birth defect. Infants carrying the rarer C2 allele who were exposed to maternal smoking of 10 or fewer cigarettes per day showed a 6.16-fold increase in risk for cleft palate only (95% confidence interval 1.09-34.7), while similar infants whose mothers smoked more than 10 cigarettes per day showed an 8.69-fold higher risk (95% confidence interval 1.57-47.8). However, the dose-response relation was not significant.

Adult↗
PubMed1995

Pharmacokinetics of methotrexate after intravenous and intramuscular injection of methotrexate-bearing positively charged liposomes to rats.

The pharmacokinetics and tissue distribution of methotrexate (MTX) were investigated after intravenous (IV) and intramuscular (IM) injection of free MTX (treatment I), freshly prepared MTX-bearing positively charged liposomes (large unilamellar vesicles), PLUVs (treatment II), and empty PLUVs mixed manually with free MTX (treatment III), 4 mg kg-1 as free MTX to rats, using HPLC assay. After 1 min IV infusion, the plasma concentrations of MTX (Cp), the area under the plasma concentration-time curve (AUC, 173 against 314 micrograms mL min-1), the terminal half-life (t1/2, 24.0 against 412 min), the mean residence time (MRT, 13.0 against 324 min), and the apparent volume of distribution at steady state (VSS, 289 against 3370 mL kg-1) were significantly larger, but the total body clearance (CL, 23.1 against 12.8 mL min-1 kg-1), the renal clearance (CLR, 8.38 against 3.09 mL min-1 kg-1), the non-renal clearance (CLNR, 14.6 against 9.56 mL min-1 kg-1), and the amount of MTX excreted in urine (Xu, 415 against 275 micrograms) were significantly lower in treatment II than in treatment I. This could be due to the fact that some of the MTX-bearing PLUVs were entrapped in tissues and the rest were present in plasma (larger MRT and Vss in treatment II), and MTX is slowly released from MTX-bearing PLUVs (longer t1/2 in treatment II). In the present HPLC assay, the concentrations of MTX represent the sum of free MTX and MTX in MTX-bearing PLUVs (larger Cp and AUC and slower CL in treatment II). Saturable formation of 7-hydroxymethotrexate from MTX was reported in rabbit blood and nonlinear disposition of MTX was also reported in rats and rabbits (lower Xu and CLR in treatment II). After 1 min IV infusion, some pharmacokinetic parameters of MTX, such as AUC, CL, CLR, CLNR, and Xu, were significantly different between treatments I and III, but nonetheless the differences were smaller than those between treatments I and II. After both IV and IM administration, the amount of MTX remaining per gram of tissue or organ in the kidney, stomach, small intestine, and large intestine was significantly smaller in treatment II than in treatment I.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1995

Injection with nondisposable needles as an important route for transmission of acute community-acquired hepatitis C virus infection in Taiwan.

A prospective case-controlled study was conducted in order to determine the transmission route of community-acquired hepatitis C virus (HCV) infection in Taiwan. Thirty-eight consecutive patients (25 men and 13 women) with acute community-acquired HCV infection and 76 age (within 3 years)- and sex-matched healthy control subjects without HCV infection were enrolled. Serum anti-HCV was tested by second generation immunoassay. The sera of 26 family members from 12 families of index patients were also tested for anti-HCV. A questionnaire covering the history of blood transfusion, surgery, intravenous drug abuse, prostitute contact, dental procedures, injection, acupuncture, tattooing, and ear-piercing was conducted among patients and control subjects. Univariate analysis revealed injection with nondisposable needles was an independent risk factor (P = 0.02, odds ratio = 4.17, 95% confidence interval = 1.24-14.47) associated with HCV infection. Other risk factors were not significant. Only 2 (7.7%) family members of index patients had an anti-HCV. In conclusion, more vigorous effort to prohibit the use of nondisposable needles should be promoted to interrupt the spread of community-acquired HCV infection in Taiwan. Of note, a significant number of patients (34.2%) contracted HCV infection without identifiable risk factors. Unidentified routes need to be investigated.

Case-Control Studies↗
PubMed1995

Detection of genotype-environment interaction in case-control studies of birth defects: how big a sample size?

Detecting interactions between risk factors in case-control studies of birth defects and other conditions usually requires increasing the sample size beyond that needed to detect marginal effects. A special case of such interaction is genotype-environment interaction in which the effects of an exposure on disease risk are modified by genetic susceptibility. When case-control studies are designed to detect marginal effects of an exposure (i.e., in the whole population), under many plausible interaction schemes, no additional case and control subjects are needed to detect genotype-environment interaction. On the contrary, inclusion of genotypic information generally can improve the statistical power of the original study. Using the example of oral clefts, maternal cigarette smoking, and genetic variation at the transforming growth factor alpha gene, we illustrate sample size and power issues in designing case-control studies when prior information is available on both the marginal effects of the exposure and the genetic factor.

Case-Control Studies↗
PubMed1995

Evaluation of sexual transmission in patients with chronic hepatitis C infection.

BACKGROUND: The transmission of hepatitis C virus (HCV) by parenteral exposure is well documented. However, a proportion of patients with acute or chronic HCV infection have an unknown source of infection. OBJECTIVES: The purpose of this study is to evaluate the role of sexual transmission in HCV infection. STUDY DESIGN: 68 patients (median age, 50 years) with chronic hepatitis C and their spouses were tested for the presence of antibody to HCV (anti-HCV) by multi-antigen and chimeric C25 antigen enzyme immunoassays and for HCV RNA by the polymerase chain reaction. Information on sexual activity and risk factors for HCV infection were obtained from all couples via a questionnaire. RESULTS: All index patients were positive for both anti-HCV and HCV RNA. Antibody to HCV was detected in four (5.9%) of their spouses. One anti-HCV-positive spouse had a history of blood transfusion while the other three (4.4%, 95% CI = 1.5-12.2%) had no known risk factors for HCV infection and thus may have been exposed to HCV via sexual transmission. Two of these 3 spouses had positive serum HCV RNA and had identical HCV genotype to the index patients. The length of sexual exposure was significantly longer in the couples who both were anti-HCV-positive than in patients whose spouses were anti-HCV negative (median: 25 vs. 10 years, P = 0.02, Mann-Whitney test). In our 68 index patients, 96% had antibodies to the recombinant proteins from the C22 (core) and C33C (NS3) regions, and 82% and 76% had antibodies to the proteins from the NS5 and C100-3 (NS4) regions. Identical anti-HCV profiles were noted in two of the four anti-HCV-positive couples. CONCLUSIONS: Our results indicate that sexual transmission, although uncommon, should be considered as a risk factor for HCV infection, especially in spouses who have had long-term intimate relationships with a chronic hepatitis C patient.

Journal Article↗
PubMed1995

A pilot, open-labelled, phase II study using oral ribavirin in the treatment of patients with chronic active hepatitis B.

BACKGROUND: Ribavirin is a synthetic purine nucleoside with demonstrated antiviral activity against several DNA and RNA viruses. OBJECTIVES: An open-labelled pilot study to evaluate the safety and effect of ribavirin in the treatment of patients with chronic active hepatitis B (CAH-B). STUDY DESIGN: 24 CAH-B patients were treated with oral ribavirin 1200 mg daily in 3 divided doses for 4 weeks. Biochemical and virological parameters were monitored at regular interval during and after treatment. RESULTS: The serum hepatitis B e antigen (HBeAg) and HBV DNA measured by dot-blot hybridization were positive in all patients before treatment. At the end of 4 weeks of therapy, the HBV DNA levels decreased in 15 (63%) patients and became undetectable in 1 (4%) of these individuals. The mean HBV DNA decreased from 288+/-78 pg/ml at baseline to 219+/-79 pg/ml at the end of the 4 weeks of treatment (p = 0.046). Eight weeks after cessation of treatment, HBV DNA was undetectable in 10 (42%) patients, and the mean HBV DNA was 46+/-23 pg/ml (p < 0.01 when compared to mean baseline value). Seven (29%) patients seroconverted from HBeAg positive to anti-HBe positive but no patients lost hepatitis B surface antigen (HBsAg) during the 8 weeks of follow-up. At the end of 4 weeks of ribavirin treatment, serum levels of alanine aminotransferase (ALT) decreased in all but 1 patient; only 1 patient normalized serum ALT at this time. The mean serum ALT decreased significantly from 416+/-72 IU/l at baseline to 179+/-35 IU/l at the end of 4 weeks of treatment (p = 0.001). Eight weeks after cessation of therapy, the mean serum ALT value was 151+/-32 IU/l (p < 0.001 when compared to mean baseline value) and 5 (21%) patients normalized serum ALT at this time. During ribavirin treatment, the main side effect was a decrease in the hemoglobin level which returned to the pretreatment level in each instance within 2 months after discontinuance of therapy. CONCLUSIONS: Results of this pilot study indicated that oral ribavirin was well tolerated in CAH-B patients and resulted in lowering of serum ALT and HBV DNA values. A randomized controlled trial is needed to fully evaluate the beneficial effects of ribavirin in CAH-B patients.

Journal Article↗
PubMed1995

Randomized controlled trial of recombinant interferon-alpha 2b in the treatment of Chinese patients with chronic hepatitis C.

To evaluate the efficacy of recombinant interferon (IFN) alpha 2b in the treatment of Chinese patients with chronic hepatitis C, a randomized controlled trial was conducted in 50 chronic hepatitis C patients: 25 patients received 3 million units of subcutaneously injected recombinant IFN-alpha 2b three times per week for 6 months, and 25 patients received no specific treatment were used as controls. At the end of the IFN treatment, 19 patients (76%) in the IFN-treated group normalized serum ALT compared with only 6 patients (24%) in the control group (p < 0.01). Relapse within 6 months after the completion of treatment occurred in 13 IFN-treated patients (68%). Normalized serum ALT was seen in 6 patients (24%) in the IFN-treated group and 1 patient (4%) in the control group 6 months after discontinuation of IFN therapy (p = 0.10). The presence of serum hepatitis C virus (HCV) RNA measured by reverse transcription-polymerase chain reaction was detected at the end of the IFN treatment in all 13 patients who relapsed after cessation of therapy. In only 3 of 25 IFN-treated patients (12%) was the presence of serum HCV RNA not detectable at the end of the IFN treatment or 6 months after cessation of therapy. No patient in the control group had undetectable serum HCV RNA during the study period. Using multivariate logistic regression analysis, the low pretreatment levels of HCV RNA, measured by a quantitative branched DNA amplification assay, was the only independent predictor of a sustained response to IFN therapy (p = 0.02).(ABSTRACT TRUNCATED AT 250 WORDS)

Alanine Transaminase↗
PubMed1995

Quantitative branched DNA assay and genotyping for hepatitis C virus RNA in Chinese patients with acute and chronic hepatitis C.

To determine the value of a quantitative branched DNA (bDNA) assay for detection of hepatitis C virus (HCV) RNA, 309 serum specimens were collected from 100 patients with acute or chronic hepatitis C for detection of HCV RNA by bDNA assay and reverse transcription-polymerase chain reaction (RT-PCR) assay. There were 256 samples positive by RT-PCR; 199 (78%) were also positive by bDNA assay. All but 1 of the remaining 53 samples negative by RT-PCR were also negative by bDNA assay. Combination of the two methods clearly demonstrated changes in HCV RNA titers during and after interferon (IFN) treatment. The most common genotype of HCV infection was Okamoto type II (Simmonds type 1b, 60.0%), followed by type III (type 2a, 16.5%) and type IV (type 2b, 8.2%); mixed or underdetermined types were noted in 15.3%. Patients with chronic type II HCV infection tended to have higher HCV RNA titers. These findings suggest that the bDNA assay is a reliable test for HCV RNA.

Base Sequence↗
PubMed1995

Lack of influence of recombinant human erythropoietin on parathyroid function in hemodialysis patients with secondary hyperparathyroidism.

The effects of recombinant human erythropoietin (rHuEPO) treatment on parathyroid function in patients on maintenance hemodialysis (HD) with secondary hyperparathyroidism (HPT) is poorly understood. We compared the levels of serum intact parathyroid hormone (PTH) and the suppressibility of PTH by intravenous calcium infusion before and after 12 weeks of rHuEPO treatment in 8 HD patients with secondary HPT. The suppressibility of PTH by calcium infusion in HD patients was also compared with that of normal subjects. After rHuEPO treatment, in HD patients hematocrit and hemoglobin levels increased significantly from 20.1 +/- 1.3% and 6.65 +/- 0.46 g/dl to 28.7 +/- 1.0% and 9.68 +/- 0.39 g/dl, respectively. The serum intact PTH levels did not change significantly (541.9 +/- 65.3 pg/ml before versus 572.9 +/- 75.3 pg/ml after rHuEPO treatment), nor did serum ionized calcium, phosphate, magnesium, aluminum, alkaline phosphatase, and 1.25(OH)2D levels. Calcium infusion significantly increased serum ionized calcium and suppressed serum PTH levels. However, the increment in serum calcium levels and the percent decrement of serum PTH showed no significant differences before and after rHuEPO treatment in HD patients. Elevations in serum calcium levels during calcium infusions were not significantly different between normal subjects and HD patients. However, the percent maximal decrement in serum PTH level was less in HD patients both before and after rHuEPO treatment than in normal subjects (-75.4 +/- 3.9 and -76.4 +/- 4.1% versus -91.4 +/- 1.4%). We conclude that rHuEPO treatment has no influence on parathyroid function in maintenance HD patients with secondary HPT. In addition, PTH secretion is less suppressed by calcium infusion in the same group of patients.

Adult↗
PubMed1995

Technetium-99m albumin scintigraphy in the diagnosis of protein-losing enteropathy: a case report.

A 34-year-old female presenting with bilateral lower leg edema and distended abdomen was admitted to our hospital. The serum albumin was 1.42g/dl. Renal function and hepatic function were normal. Urinalysis did not show proteinuria. Tc-99m albumin scintigraphy was arranged for this patient to rule out protein-losing enteropathy. The results demonstrated loss of albumin into the intestines. We conclude that Tc-99m albumin scintigraphy of the abdomen is a valuable adjunct in the diagnosis of protein-losing enteropathy.

Adult↗
PubMed1995

[Swallowing of fixed denture following general anesthesia--a case report].

Dental injury is a common complication associated with endotracheal general anesthesia. According to a study in Japan, the incidence of dental injury caused by endotracheal intubation is 0.69%. In one study in our country, evaluation of the oral condition was performed before, during and after anesthesia, and the frequency of dental trauma is as high as 12.1%. Fragment(s) of tooth or denture may cause serious, or even fatal complications. We report a case of swallowing of fixed denture following endotracheal general anesthesia. Our accident involved a 33-yr-old male who had experienced bilateral auditory impairment as a result of chronic otitis media. The patient underwent right modified radical mastoidectomy under endotracheal general anesthesia. It might well be that the patient's maxillary fixed denture was loosened at the time of endotracheal intubation. However, patient's denture was normal in appearance and not much attention was paid to it. During his stay at the post-anesthesia care unit, he might have unconsciously swallowed his denture. Verification was later made by X-ray. On careful observation, his denture was found in the feces during defecation 30 h post-operatively.

Adult↗
PubMed1995

Detection of antibody to M2 mitochondrial antigen in Chinese patients with primary biliary cirrhosis.

BACKGROUND: Antimitochondrial antibodies (AMA) are present in more than 90% of patients with primary biliary cirrhosis (PBC). However, AMA are not specific for PBC; they can be observed in nonhepatic disease. It has been reported that antibody of M2 mitochondrial antigen (anti-M2) is specific for PBC. The aim of the present study is to clarify the role of anti-M2 in the diagnosis of PBC. METHODS: Sera from 27 patients with PBC, 62 normal subjects, 18 patients with chronic hepatitis B and 30 patients with chronic hepatitis C were obtained for the detection of anti-M2 and AMA. The anti-M2 assay was performed by enzyme immunoassay (EIA) and the AMA test was performed by indirect immunofluorescent method. RESULTS: Twenty-four (88.9%) of the serum specimens from the patients with PBC and one (0.9%) of the 110 serum specimens from the non-PBC groups were positive for AMA. In contrast, twenty-five (92.6%) of the 27 PBC sera and five (4.5%) of the 110 non-PBC sera were positive for anti-M2. Most of the PBC sera contained high titers of anti-M2 and all the false-negative specimens disclosed low titers of anti-M2. CONCLUSIONS: Although the anti-M2 assay used in the present study seemed not superior to the conventional AMA test in the sense of specificity, it had the advantage of being able to provide quantitative results. Since the presence of high titer anti-M2 is very specific for PBC, this assay may have a role in the diagnosis of equivocal PBC.

Adult↗