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CC BY-NC-ND 4.0 · Ann Natl Acad Med Sci 2021; 57(01): 62-64
DOI: 10.1055/s-0040-1722105
Case Report

An Interesting Case of Autoimmune Liver Disease

Paras Kathuria
1   Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
,
Shilpa Arora
1   Department of Medicine, Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
,
Rahul Karna
2   Maulana Azad Medical College, New Delhi, India
,
Naresh Kumar
3   Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
,
Suresh Kumar
3   Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
,
Premashis Kar 
3   Maulana Azad Medical College and Associated Lok Nayak Hospital, New Delhi, India
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Abstract

Autoimmune liver diseases (AILD) are part of a broad spectrum of liver diseases with autoimmune etiology, usually present individually but at times have overlapping features. We present the case of a 60-year-old lady presenting with fatigue, itching and right upper quadrant abdominal pain. Further investigation showed cholestatic pattern of liver enzymes and evidence of portal hypertension without any evidence of extrahepatic obstruction. Autoimmune markers and liver biopsy showed overlapping features of both autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC), which is a separate diagnosis known as overlap syndrome, but by applying appropriate criterion, we were able to make a definite diagnosis of PBC. Differentiating PBC from overlap syndrome was important as therapy of both are different.

Keywords

autoimmune hepatitis - cholestasis - primary biliary cirrhosis


Publication History

Article published online:
30 December 2020

© 2020. National Academy of Medical Sciences (India). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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  • References

  • 1 Chazouillères O, Wendum D, Serfaty L, Montembault S, Rosmorduc O, Poupon R. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: clinical features and response to therapy. Hepatology 1998; 28 (02) 296-301
    CrossrefPubMedSearch in Google Scholar
  • 2 Alvarez F, Berg PA, Bianchi FB. et al. International Autoimmune Hepatitis Group Report: review of criteria for diagnosis of autoimmune hepatitis. J Hepatol 1999; 31 (05) 929-938
    CrossrefPubMedSearch in Google Scholar
  • 3 Sarin SK, Monga R, Sandhu BS, Sharma BC, Sakhuja P, Malhotra V. Primary biliary cirrhosis in India. Hepatobiliary Pancreat Dis Int 2006; 5 (01) 105-109
    PubMedSearch in Google Scholar
  • 4 Amarapurkar DN, Patel ND. Spectrum of autoimmune liver diseases in western India. J Gastroenterol Hepatol 2007; 22 (12) 2112-2117
    CrossrefPubMedSearch in Google Scholar
  • 5 Czaja AJ. The overlap syndromes of autoimmune hepatitis. Dig Dis Sci 2013; 58 (02) 326-343
    PubMedSearch in Google Scholar
  • 6 Bairy I, Berwal A, Seshadri S. Autoimmune hepatitis - Primary biliary cirrhosis overlap syndrome. J Clin Diagn Res 2017; 11 (07) OD07-OD09
    PubMedSearch in Google Scholar
  • 7 Rust C, Beuers U. Overlap syndromes among autoimmune liver diseases. World J Gastroenterol 2008; 14 (21) 3368-3373
    CrossrefPubMedSearch in Google Scholar
  • 8 Chazouillères O, Wendum D, Serfaty L, Rosmorduc O, Poupon R. Long term outcome and response to therapy of primary biliary cirrhosis-autoimmune hepatitis overlap syndrome. J Hepatol 2006; 44 (02) 400-406
    CrossrefPubMedSearch in Google Scholar
  • 9 Duclos-Vallée JC, Hadengue A, Ganne-Carrié N, Robin E, Degott C, Erlinger S. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome. Corticoresistance and effective treatment by cyclosporine A. Dig Dis Sci 1995; 40 (05) 1069-1073
    CrossrefPubMedSearch in Google Scholar