A patient with primary biliary cholangitis, autoimmune hepatitis, and primary sclerosing cholangitis variant syndrome.

Autoimmune hepatitis Normal serum alkaline phosphatase level Primary biliary cholangitis Primary sclerosing cholangitis Variant syndrome

Journal

Journal of translational autoimmunity
ISSN: 2589-9090
Titre abrégé: J Transl Autoimmun
Pays: Netherlands
ID NLM: 101759413

Informations de publication

Date de publication:
2020
Historique:
received: 12 12 2019
accepted: 13 12 2019
entrez: 4 8 2020
pubmed: 4 8 2020
medline: 4 8 2020
Statut: epublish

Résumé

Overlap between autoimmune hepatitis (AIH) and either primary biliary cholangitis (PBC) or primary sclerosing cholangitis (PSC) is not rare and has extensively been reported. We herein report the first well documented case of triple overlap. A 68-year-old male patient presented with asymptomatic PBC including normal alkaline phosphatase serum level, developed AIH five years later, associated with magnetic resonance cholangiopancreatography biliary changes typical for PSC. Despite treatment with ursodeoxycholic acid and mycophenolate mofetil, owing to prednisone and azathioprine intolerance, he continued to have interface hepatitis and developed increasing fibrosis at follow-up liver biopsy. Our case report raises awareness for this rare and difficult to diagnose and treat clinical phenotype.

Identifiants

pubmed: 32743518
doi: 10.1016/j.jtauto.2019.100033
pii: S2589-9090(19)30033-4
pii: 100033
pmc: PMC7388380
doi:

Types de publication

Case Reports

Langues

eng

Pagination

100033

Informations de copyright

© 2019 The Authors.

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Auteurs

Benedetta Terziroli Beretta-Piccoli (B)

Epatocentro Ticino, Lugano, Switzerland.
Institute of Liver Studies, MowatLabs, King's College Hospital, London, UK.

Luca Mazzucchelli (L)

Cantonal Pathology Institute, Locarno, Switzerland.

Chiara Taiana (C)

Studio Medico, Canobbio, Switzerland.

Giuseppe Mossi (G)

Studio Medico, Maggia, Switzerland.

Corrado Usai (C)

Radiology Department, Regional Hospital EOC, Locarno, Switzerland.

Diego Vergani (D)

Institute of Liver Studies, MowatLabs, King's College Hospital, London, UK.

Giorgina Mieli-Vergani (G)

Paediatric Liver, GI and Nutrition Centre, MowatLabs, King's College Hospital, London, UK.

Classifications MeSH