[Lung involvement in patients with primary biliary cirrhosis].

HISTORY AND CLINICAL FINDINGS: For several months a 29 years old woman suffered from dry cough, dyspnea, and weakness. The clinical examination was without any abnormal findings.

INVESTIGATIONS: Liver function tests and erythrocyte sedimentation rate were raised. High resolution CT chest scan showed multiple patchy alveolar and interstitial infiltrates. Transbronchial and surgical lung biopsy confirmed a moderate alveolitis with granulomas.

DIAGNOSIS: primary biliary cirrhosis (pbc) complicated by lung disease could be diagnosed through increased titer of antimitochondrial antibodies and the laparoscopy.

TREATMENT AND COURSE: Under treatment of pbc with either corticosteroids or Ursodeoxycholic acid, liver enzymes decreased and pulmonary symptoms disappeared.

CONCLUSION

To detect lung involvement in patients with pbc early, lung function tests and diffusion capacity should be monitored regularly. An otherwise unexpected rise in liver function tests, particularly in patients with underlying interstitial lung disease or sarcoid granulomatosis should promptly be investigated further.