Overlay of autoimmune cholangitis and autoimmune hepatitis
Introduction and Objectives: The ''overlap syndrome'' is a variant of autoimmune hepatitis (AIH) in addition to cholestatic liver disease. AIH can present concurrently with primary biliary cholangitis (PBC) 7% to 13%, primary sclerosing cholangitis (PSC) 6% to 11% or autoimmune c...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | Annals of Hepatology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268122001636 |
| _version_ | 1811320034834776064 |
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| author | KM Cervantes Espinoza L Juárez Chávez DG Ibarra Salazar |
| author_facet | KM Cervantes Espinoza L Juárez Chávez DG Ibarra Salazar |
| author_sort | KM Cervantes Espinoza |
| collection | DOAJ |
| description | Introduction and Objectives: The ''overlap syndrome'' is a variant of autoimmune hepatitis (AIH) in addition to cholestatic liver disease. AIH can present concurrently with primary biliary cholangitis (PBC) 7% to 13%, primary sclerosing cholangitis (PSC) 6% to 11% or autoimmune cholangitis (AIC) 3% to 9%, the rarest and associated with a poor prognosis. Diagnosis requires biochemical alteration, immunological studies and biopsy, plus the exclusion of viral, toxic, metabolic and hereditary etiologies. Therapy, including corticosteroids, ursodeoxycholic acid and immunosuppressants, should be individualized and guided by the severity of the cholestasis findings. Materials and Methods: 66-year-old female. She presented in 2018 with the detection of hepatic steatosis, a weight loss of 32 kg in 2 years. Asthenia, adynamia, pruritus and scleral jaundice progressing to generalized. In laboratories: BT 11.37 (BI 8.5), AST 187, ALT 148, GGT 1761, FA 1819, ANAs positive anti centromere 1:40 and Hep-2 cells 1:640, cholangioresonance without data of CEP. Treatment with ursodeoxycholic acid was started, with no response, and a liver biopsy was performed compatible with HAI+CAI, Fig. 1 and 2. We started therapy with prednisone and azathioprine. Conclusions: Recognizing that AIH and IAC are diseases with high morbidity that progress to chronic liver damage with fibrosis and cirrhosis, their early identification would help in the establishment of timely and effective treatment. Funding: The resources used in this study were from the hospital without any additional financing Declaration of interest: The authors declare no potential conflicts of interest. |
| first_indexed | 2024-04-13T12:52:25Z |
| format | Article |
| id | doaj.art-cf9186f3fd4a4b96a2a26e421cd9d709 |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-13T12:52:25Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-cf9186f3fd4a4b96a2a26e421cd9d7092022-12-22T02:46:10ZengElsevierAnnals of Hepatology1665-26812022-12-0127100821Overlay of autoimmune cholangitis and autoimmune hepatitisKM Cervantes Espinoza0L Juárez Chávez1DG Ibarra Salazar2Internal Medicine. Regional General Hospital N. 1 “Dr. Carlos Mac Gregor Sanchez Navarro”. MexicoGastroenterology Service. HGZ 1A “Rodolfo Antonio de Mucha Macias”. MexicoPathological Anatomy Service. HGZ 1A “Rodolfo Antonio de Mucha Macias”. MexicoIntroduction and Objectives: The ''overlap syndrome'' is a variant of autoimmune hepatitis (AIH) in addition to cholestatic liver disease. AIH can present concurrently with primary biliary cholangitis (PBC) 7% to 13%, primary sclerosing cholangitis (PSC) 6% to 11% or autoimmune cholangitis (AIC) 3% to 9%, the rarest and associated with a poor prognosis. Diagnosis requires biochemical alteration, immunological studies and biopsy, plus the exclusion of viral, toxic, metabolic and hereditary etiologies. Therapy, including corticosteroids, ursodeoxycholic acid and immunosuppressants, should be individualized and guided by the severity of the cholestasis findings. Materials and Methods: 66-year-old female. She presented in 2018 with the detection of hepatic steatosis, a weight loss of 32 kg in 2 years. Asthenia, adynamia, pruritus and scleral jaundice progressing to generalized. In laboratories: BT 11.37 (BI 8.5), AST 187, ALT 148, GGT 1761, FA 1819, ANAs positive anti centromere 1:40 and Hep-2 cells 1:640, cholangioresonance without data of CEP. Treatment with ursodeoxycholic acid was started, with no response, and a liver biopsy was performed compatible with HAI+CAI, Fig. 1 and 2. We started therapy with prednisone and azathioprine. Conclusions: Recognizing that AIH and IAC are diseases with high morbidity that progress to chronic liver damage with fibrosis and cirrhosis, their early identification would help in the establishment of timely and effective treatment. Funding: The resources used in this study were from the hospital without any additional financing Declaration of interest: The authors declare no potential conflicts of interest.http://www.sciencedirect.com/science/article/pii/S1665268122001636 |
| spellingShingle | KM Cervantes Espinoza L Juárez Chávez DG Ibarra Salazar Overlay of autoimmune cholangitis and autoimmune hepatitis Annals of Hepatology |
| title | Overlay of autoimmune cholangitis and autoimmune hepatitis |
| title_full | Overlay of autoimmune cholangitis and autoimmune hepatitis |
| title_fullStr | Overlay of autoimmune cholangitis and autoimmune hepatitis |
| title_full_unstemmed | Overlay of autoimmune cholangitis and autoimmune hepatitis |
| title_short | Overlay of autoimmune cholangitis and autoimmune hepatitis |
| title_sort | overlay of autoimmune cholangitis and autoimmune hepatitis |
| url | http://www.sciencedirect.com/science/article/pii/S1665268122001636 |
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