Comparison of Pulmonary Function Tests in Asymptomatic Biliary Liver Cirrhosis versus Healthy Individuals
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Background: Primary biliary cirrhosis may be accompanied by pulmonary abnormalities, although their frequency and relationship with clinically symptomatic disease remain uncertain. Objective: To compare pulmonary-function parameters in patients with primary biliary cirrhosis and healthy individuals and to assess differences between symptomatic and asymptomatic patients. Methods: This prospective comparative observational study included 26 patients with primary biliary cirrhosis and 19 healthy controls at Lahore General Hospital from January 2021 to January 2023. Nineteen patients were symptomatic and seven were asymptomatic. Spirometry, lung volumes, diffusing capacity for carbon monoxide, ventilation distribution, arterial blood gases, exercise capacity, and right-to-left shunting were assessed. Group means were compared using independent-samples tests, while categorical findings and the relationship between DLCO and exercise capacity were also evaluated. Results: Fourteen patients (53.8%) had at least one abnormal pulmonary-function finding. Abnormalities occurred in 13/19 symptomatic patients (68.4%) and 1/7 asymptomatic patients (14.3%; p=0.026). Mean DLCO was lower in patients than controls (76.1±16.1% vs 88.1±12.1% predicted; mean difference −12.0, 95% CI −20.5 to −3.5; p=0.007). Symptomatic patients had lower DLCO than asymptomatic patients (70.9±14.6% vs 84.5±13.8%; p=0.050). DLCO correlated positively with maximum working capacity (r=0.74). Conclusion: Pulmonary abnormalities, particularly reduced DLCO, were frequent in primary biliary cirrhosis and were more prominent among symptomatic patients
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1. Sargın G, Senturk T, Borazan S, Coskun A. Primary biliary cholangitis in patients with systemic sclerosis: unmasking the true face of Reynold syndrome. Egypt Rheumatol. 2019.
2. Mallea J, Bolan C, Cortese C, Harnois D. Cystic fibrosis-associated liver disease in lung transplant recipients. Liver Transpl. 2019.
3. Boëlle PY, Debray D, Guillot L, Clement A, Corvol H; French CF Modifier Gene Study Investigators. Cystic fibrosis liver disease: outcomes and risk factors in a large cohort of French patients. Hepatology. 2019;69(4):1648-56.
4. Mazzi V. MIG chemokine in primary biliary cirrhosis. Clin Ter. 2019;170(3):e211-5.
5. She WH, Chok KS, Li IW, Ma KW, Sin SL, Dai WC, et al. Pneumocystis jirovecii-related spontaneous pneumothorax, pneumomediastinum and subcutaneous emphysema in a liver transplant recipient: a case report. BMC Infect Dis. 2019;19(1):66.
6. Forde KA, Fallon MB, Krowka MJ, Sprys M, Goldberg DS, Krok KL, et al. Pulse oximetry is insensitive for detection of hepatopulmonary syndrome in patients evaluated for liver transplantation. Hepatology. 2019;69(1):270-81.
7. Ni P, Men R, Shen M, Wang T, Huang C, Fan X, et al. Concomitant Sjögren syndrome was not associated with a poorer response or outcomes in ursodeoxycholic acid-treated patients with primary biliary cholangitis. Can J Gastroenterol Hepatol. 2019;2019.
8. Han D, Liu J, Jin E, He W. Liver assessment using Gd-EOB-DTPA-enhanced magnetic resonance imaging in patients with primary biliary cholangitis. Jpn J Radiol. 2019;37(5):412-9.
9. Couperus LE, Vliegen HW, Sorgdrager BJ, den Dulk AC, Beeres SLMA, Sarton EYA, et al. Prognostic importance of increased right ventricular afterload in orthotopic liver transplantation recipients with end-stage cirrhosis. Heart Lung Circ. 2019;28(6):893-900.
10. Rojas E, Aktas A, Parikh H, Khawaja US, Pergament K. Platypnea-orthodeoxia syndrome in a patient with cryptogenic liver cirrhosis: an elusive cause of hypoxemia. Cureus. 2019;11(1).
11. Lepri G, Bellando-Randone S, Matucci-Cerinic M, Allanore Y. Systemic sclerosis and primary biliary cholangitis: an overlapping entity? J Scleroderma Relat Disord. 2019;4(2):111-7.
12. Hossain S, Choudhury M, Yeasmin S, Haque M, Hossain F. Assessment of health-related quality of life and functional disability among scleroderma patients in Bangladesh. Ann Rheum Dis. 2019.
13. Jalil BA, El-Kersh K. Pulmonary arterial hypertension diagnosed 19 years after liver transplant: what is the culprit? Am J Respir Crit Care Med. 2019;199:A3640.
14. O’Murchadha LT, Roche S, Fahy RJ. Lung fibrosis with persistent elevation of antimitochondrial and pyruvate dehydrogenase antibodies: a pulmonary manifestation of quiescent primary biliary cholangitis? Am J Respir Crit Care Med. 2019;199:A6297.
15. Alkoky H, Lazarus M. Should all patients with anticentromere antibodies be referred for a rheumatology assessment? Ann Rheum Dis. 2019.