Article Text

AB1033 Impact of autoimmune liver disesase on bone mineral density
  1. H. Kchir1,
  2. N. Maamouri1,
  3. N. Belkahla1,
  4. H. Sahli2,
  5. B. Mohsni1,
  6. N. Naija1,
  7. S. Chouaib1,
  8. S. Sallemi2,
  9. N. Ben Mami1
  1. 1Gastroenterology
  2. 2Rheumatology, La Rabta Hospital, tunis, Tunisia


Background Bone involvement is actually well demonstrated during chronic hepatopathies. Its frequency is not negligible and seems more frequent during auto-immune hepatopathies.

Objectives To study bone mineral density profile of patients suffering from chronic hepathopathies and to establish characteristics of osteoporotic patients.

Methods We carried a retrospective study from January 1996 to December 2009 including all cases of auto-immune hepatopathies [auto-immune hepatitis (AIH), primary biliary cirrhosis (PBC), Primary sclerosing cholangitis (PSC), Overlap syndrome PBC-AIH (OS1) and PSC-AIH (OS2)], diagnosed in the department of gastroenterology B in Rabta’s Hospital. We retained all patients having a bone densitometry (BD).

Results During the period of the study, 85 patients were included. Thirty one had a BD: 20 PBC, 2 AIH, 7 OS1, 1 PSC, 1 OS2. BD was normal in 8 cases (25%): 5 PBC and 3 OS1. Osteopenia was reported in 6 cases (19.3%): 4PBC, 1 AIH and 1 OS1. Seventeen patients had osteoporosis (54%): 11 PBC, 1 AIH, 3 OS1, 1 PSC and 1 OS2. The mean T-score was (-3.35 DS) on lumbar spine and (-1.93 DS) on femur. The mean Z score was (-2.1 DS) on lumbar spine and (-0.7 DS) on femur. The mean age of osteoporotic patients was 56,8 years (extreme: 38-76 years). There were 16 women (94%) and one man. Among women, 13 were already postmenopausal (81%). Research of risk factors of osteoporosis revealed a corticotherapy in all cases of OS1 and smoking in 1 case (9% CBP). Biological tests showed transaminase 2-fold above normal values, in 8 cases (47%) with gammaglutamyl transpeptidase ≥5-fold above normal values in 6 patients (35%). The mean rate of bilirubin was 58 mg/l. The immunological tests revealed the presence of anti-mitochondrion-antibodies in 11 cases (9 PBC and 2 OS1), antinuclear-antibodies in 3 cases (2 OS1 and 1 AIH) and anti-smooth-muscle antibodies in 3 cases (2 OS1 and 1 AIH). Associated autoimmune manifestations were observed in 10 cases. A fibrosis degree ≥2 (according to Metavir score) was noted in 10 cases of which 6 were at the stage of cirrhosis at the time of the diagnosis (37%).

Conclusions In our series, more than half of the patients with auto-immune liver diseases and having had a BD were osteoporotic. Bone loss is generally associated with PBC and is more frequent in postmenopausal women.

Disclosure of Interest None Declared

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