The syndrome of primary biliary cirrhosis and limited scleroderma (the CREST syndrome) is described in 22 patients. The syndrome is expanded to include a serologic marker - the anticentromere antibody - and keratoconjunctivitis sicca. The acronym‘PACK’(primary biliary cirrhosis, anticentromere antibody,CREST syndrome, andkeratoconjunctivitis sicca) with‘syndrome’is suggested to facilitate recall of the various components of this
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