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Primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC) are uncommon liver diseases of unknown etiology. Reported clustering of PBC cases may be due to environmental factors. Individuals with PBC have a high prevalence of thyroid disease and thyroid disease is reportedly more prevalent near Superfund toxic waste sites (SFS). Free rpc for 3ds max. The objective of this study was to examine the prevalence and potential clustering of individuals with PBC and PSC near SFS. De‐identified clinical and demographic data were used to determine the observed prevalence for each New York City zip code (n = 174) and borough (n = 5) of patients with PBC (PBC‐OLT) or PSC (PSC‐OLT) who were listed for liver transplantation. The expected prevalence was calculated using Organ Procurement and Transfer Network (OPTN) and U.S. Both PBC‐OLT patients and patients not listed for liver transplantation (PBC‐MSSM) were included in the cluster analysis.
Prevalence ratios of PBC‐OLT and PSC‐OLT cases were compared for each zip code and for each borough with regard to the proximity or density of SFS, respectively. SaTScan software was used to identify clusters of PBC‐OLT cases and PBC‐MSSM cases. Prevalence ratio of PBC‐OLT, not PSC‐OLT, was significantly higher in zip codes containing or adjacent to SFS (1.225 vs. 0.670, respectively, P =.025).
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The borough of Staten Island had the highest prevalence ratio of PBC‐OLT cases and density of SFS. Significant clusters of both PBC‐OLT and PBC‐MSSM were identified surrounding SFS. In conclusion, toxin exposure may be a risk factor influencing the clustering of PBC cases.
(H EPATOLOGY 2006;43:525–531.). Primary biliary cirrhosis (PBC) is a chronic, cholestatic liver disease of unclear etiology characterized by nonsuppurative intrahepatic portal tract inflammation and bile duct destruction, which may progress to cirrhosis. Elevated serum IgM levels and high titer serum reactivity against mitochondrial autoantigens are the other hallmarks of the disease., Most individuals diagnosed with PBC, typically middle‐aged women, also suffer from other autoimmune diseases, such as autoimmune thyroid disease. The role of retroviral infection in the disease remains undefined and controversial., Large geographic variations in the prevalence of PBC have been reported. - Differences in both genetic susceptibility factors and exposure to environmental toxins are widely believed to contribute to this variability in the prevalence of PBC.