Abstract: Objective To analyze the occurrence, clinical characteristics, and clinical outcomes of Hashimoto′s thyroiditis in patients with primary biliary cholangitis. Methods Sixty patients who were diagnosed with primary biliary cholangitis and underwent thyroid examination in Beijing Chaoyang Hospital, Capital Medical University between February 2020 and February 2022 were selected. They were divided into the occurrence group (n=35) and the non-occurrence group (n=25) according to whether Hashimoto′s thyroiditis occurred. The clinical characteristics and prognosis of the occurrence and non-occurrence groups were compared. Results In the occurrence group, the Child-Pugh grade, the proportion of cirrhosis and other symptoms such as malaise, dyspepsia, abdominal distension, edema, and the levels of immunoglobulin A (IgA), thyroglobulin antibody, and thyroid peroxidase antibody were (8.3±1.2), 85.7%, 91.4%, 85.7%, 91.4%, 85.7%, (2.9±1.2) g/L, (217.5± 102.3) IU/mL, and (192.6±62.4) IU/mL, which were higher than those in the non-occurrence group [(5.2±1.1), 48.0%, 60.0%, 40.0%, 48.0%, 48.0%, 48.0%, (2.0±0.5) g/L, (10.2±3.6) IU/mL, and (11.4±4.6) IU/mL, respectively]. The levels of total cholesterol, triglycerides, low-density lipoprotein (LDL), and complement C3 in the occurrence group were (4.3±1.2)μmol/L, (1.2±0.2) μmol/L, (2.5±0.2) mmol/L, (0.5±0.2) g/L, respectively, which were lower than those in the non-occurrence group [(5.8±2.3) μmol/L, (1.6±0.8)μmol/L, (3.0±1.2) mmol/L, and (0.8±0.2) g/L, P<0.05]. Thirty-five patients were followed up until February 2023. Ten (28.6%) patients developed peritoneal effusion (n=5), hepatic insufficiency (n=4), and hepatic encephalopathy (n=1), and 2 (5.7%) patients died due to postoperative cerebral hemorrhage. Five (14.3%) patients developed recurrent postoperative hemorrhage, 2 died within one year, and the survival rate was 94.3%. Conclusion Patients with primary biliary cholangitis have a high probability of developing Hashimoto′s thyroiditis, and their prognosis is poor. Child-Pugh grade of liver function, thyroglobulin antibody and thyroid peroxidase antibody are the risk factors that affect the prognosis of the above cases.

Key words: Primary biliary cholangitis, Hashimoto′s thyroiditis, Clinical features, Clinical regression