Amelioration of limited mouth opening after treatment of primary biliary cholangitis: A case report

Takeshi Kaneuji, Daigo Yoshiga, Wataru Ariyoshi, Ikuo Nakamichi, Hironori Tanimoto, Junpei Tanaka, Ikuya Miyamoto, Manabu Habu, Sho Mitsugi, Tatsuji Nishihara, Tetsu Takahashi, Kazuhiro Tominaga, Izumi Yoshioka

Research output: Contribution to journalArticlepeer-review

Abstract

Primary biliary cholangitis is a slow-progressing autoimmune disease of the liver characterized by the presence of portal inflammation and immune-mediated destruction of the intrahepatic bile ducts. Herein, we report a case of temporomandibular joint disorder that concurred with primary biliary cholangitis. A 54-year-old woman presented to us with severe pain on the left side of the temporomandibular joint and difficulty in mouth opening. We used pharmacotherapy, occlusal sprint, and arthrocentesis for the treatment; however, there was no improvement. Magnetic resonance imaging revealed malposition of the articular disk on the left side of the joint and joint effusion. Thus, we performed arthroscopic surgery under general anesthesia. Postoperatively, she developed impaired liver function and itchiness of the skin. A liver biopsy was performed by a hepatologist, and a diagnosis of primary biliary cholangitis was made, as suspected. The temporomandibular joint pain and trismus persisted postoperatively; however, these symptoms improved after primary biliary cholangitis therapy. Thus, we suggest a relationship between temporomandibular joint disorder and primary biliary cholangitis from this disease trajectory and suspect that interleukin-17 may play an important role in the pathogenesis of temporomandibular joint disorder.

Original languageEnglish
Pages (from-to)342-345
Number of pages4
JournalJournal of Oral and Maxillofacial Surgery, Medicine, and Pathology
Volume31
Issue number5
DOIs
Publication statusPublished - 2019 Sep

Keywords

  • IL-17
  • PBC
  • Primary biliary cholangitis
  • TMJ
  • Temporomandibular joint disease

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery
  • Pathology and Forensic Medicine
  • Otorhinolaryngology

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