Reviewer's report
Title:Concurrent Autoimmune Pancreatitis and Primary Biliary Cirrhosis: a Rare
Case Report and Review of the Literature
Version:1Date:18 October 2013
Reviewer: Hideaki Miura
Reviewer's report:
Major compulsory revisions
1. An initial predominant clinical feature in the present case was obstructive
jaundice caused by the enlargement of pancreas due to AIP. Why did the
authors administer UDCA? UDCA has choleretic action and is usually thought to
be contraindication in case of biliary obstruction with hyperbilirubinemia. Did
administration of UDCA start after nasobiliary drainage?
2. As the authors demonstrated, the diagnosis of AIP is undoubtedly right with
reference to diagnostic criteria. However, diagnosis of PBC was made only by
the fact that the patient was serologically positive for AMA when liver dysfunction
due to AIP was overt. Diagnosis of PBC should be made carefully when there is
other disease that causes hepatic cholestasis. This manuscript seems to be too
lack of information about PBC to demonstrate synchronous development of AIP
and PBC. Had liver dysfunction that was diagnostic as typical PBC persisted
before development of obstructive jaundice? Otherwise, a presence of PBC
should be shown histologically.
3. The titer of AMA and the value of AMA (M2) should be described.
4. The authors concluded that there were not extrapancreatic lesions; however,
CT image demonstrated enhancement and wall thickening of gallbladder and
common bile duct, suggesting the presence of some inflammation. Authors say
that these figures are possibly due to obstruction by enlarged pancreas.
However, these pictures also resemble those of gall bladder and bile duct
involvement seen in AIP.
4. The discussion is somewhat too long, and seems like review article in part.
The reviewer suggests the authors to rewrite the discussion focusing on the
importance of this case report.
5. This manuscript is full of misspelled words and wrong terms.
aotuimmune, pruritis, comfirmed, administaed, glutamyltrasferase,
immunocomprised, chinese, fibrilation, asprin, hastory, arythmia, alanine
transaminase, etc. ..................
The authors are advised to a native English-speaking scientific proofreader to
revise their article.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interest.
Reviewer's report
Title:Concurrent Autoimmune Pancreatitis and Primary Biliary Cirrhosis: a Rare
Case Report and Review of the Literature
Version:1Date:18 October 2013
Reviewer: Hideaki Miura
Reviewer's report:
Major compulsory revisions
1. An initial predominant clinical feature in the present case was obstructive
jaundice caused by the enlargement of pancreas due to AIP. Why did the
authors administer UDCA? UDCA has choleretic action and is usually thought to
be contraindication in case of biliary obstruction with hyperbilirubinemia. Did
administration of UDCA start after nasobiliary drainage?
2. As the authors demonstrated, the diagnosis of AIP is undoubtedly right with
reference to diagnostic criteria. However, diagnosis of PBC was made only by
the fact that the patient was serologically positive for AMA when liver dysfunction
due to AIP was overt. Diagnosis of PBC should be made carefully when there is
other disease that causes hepatic cholestasis. This manuscript seems to be too
lack of information about PBC to demonstrate synchronous development of AIP
and PBC. Had liver dysfunction that was diagnostic as typical PBC persisted
before development of obstructive jaundice? Otherwise, a presence of PBC
should be shown histologically.
3. The titer of AMA and the value of AMA (M2) should be described.
4. The authors concluded that there were not extrapancreatic lesions; however,
CT image demonstrated enhancement and wall thickening of gallbladder and
common bile duct, suggesting the presence of some inflammation. Authors say
that these figures are possibly due to obstruction by enlarged pancreas.
However, these pictures also resemble those of gall bladder and bile duct
involvement seen in AIP.
4. The discussion is somewhat too long, and seems like review article in part.
The reviewer suggests the authors to rewrite the discussion focusing on the
importance of this case report.
5. This manuscript is full of misspelled words and wrong terms.
aotuimmune, pruritis, comfirmed, administaed, glutamyltrasferase,
immunocomprised, chinese, fibrilation, asprin, hastory, arythmia, alanine
transaminase, etc. ..................
The authors are advised to a native English-speaking scientific proofreader to
revise their article.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interest.
Please review this paper.
user
Reviewer's report
Title:Concurrent Autoimmune Pancreatitis and Primary Biliary Cirrhosis: a Rare
Case Report and Review of the Literature
Version:1Date:18 October 2013
Reviewer: Hideaki Miura
Reviewer's report:
Major compulsory revisions
1. An initial predominant clinical feature in the present case was obstructive
jaundice caused by the enlargement of pancreas due to AIP. Why did the
authors administer UDCA? UDCA has choleretic action and is usually thought to
be contraindication in case of biliary obstruction with hyperbilirubinemia. Did
administration of UDCA start after nasobiliary drainage?
2. As the authors demonstrated, the diagnosis of AIP is undoubtedly right with
reference to diagnostic criteria. However, diagnosis of PBC was made only by
the fact that the patient was serologically positive for AMA when liver dysfunction
due to AIP was overt. Diagnosis of PBC should be made carefully when there is
other disease that causes hepatic cholestasis. This manuscript seems to be too
lack of information about PBC to demonstrate synchronous development of AIP
and PBC. Had liver dysfunction that was diagnostic as typical PBC persisted
before development of obstructive jaundice? Otherwise, a presence of PBC
should be shown histologically.
3. The titer of AMA and the value of AMA (M2) should be described.
4. The authors concluded that there were not extrapancreatic lesions; however,
CT image demonstrated enhancement and wall thickening of gallbladder and
common bile duct, suggesting the presence of some inflammation. Authors say
that these figures are possibly due to obstruction by enlarged pancreas.
However, these pictures also resemble those of gall bladder and bile duct
involvement seen in AIP.
4. The discussion is somewhat too long, and seems like review article in part.
The reviewer suggests the authors to rewrite the discussion focusing on the
importance of this case report.
5. This manuscript is full of misspelled words and wrong terms.
aotuimmune, pruritis, comfirmed, administaed, glutamyltrasferase,
immunocomprised, chinese, fibrilation, asprin, hastory, arythmia, alanine
transaminase, etc. ..................
The authors are advised to a native English-speaking scientific proofreader to
revise their article.
Level of interest: An article of limited interest
Quality of written English: Not suitable for publication unless extensively edited
Statistical review: No, the manuscript does not need to be seen by a statistician.
Declaration of competing interests:
I declare that I have no competing interest.
assistant