Occurrence of Autoimmune Hepatitis During the Course of Primary Biliary Cirrhosis: Report of Two Cases

Yokosuka, Osamu; Hirasawa, Yuichi; Imazeki, Fumio; Nagao, Keiichi; Saisho, Hiromitsu

doi:10.1007/s10620-006-3083-5

Cited by 9 publications

(7 citation statements)

References 12 publications

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“…We previously reported that corticosteroids are effective for AIH with acute presentation [2] and that they are also effective for overlap syndrome having AIH and PBC features with acute transaminase elevation [10]. Ichai et al [12] indicated that there is a point beyond which AIH cannot be salvaged by drug therapy, and this point can be defined only by assessing the immediate response to corticosteroid treatment [4].…”

Section: Discussionmentioning

confidence: 99%

“…Some patients within the spectrum of autoimmune liver disease present with characteristics of both PBC and AIH and are commonly classified as having an ‘overlap syndrome’ [5, 10]. In AIH patients, AMA is occasionally seen at low titers, but an AMA anti-pyruvate dehydrogenase complex-E2 (AMA-M2) pattern, which is specific to PBC, is rarely detected [5].…”

Section: Introductionmentioning

confidence: 99%

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Acute Liver Failure in an Antimitochondrial Antibody-Positive 63-Year-Old Man

Wakamatsu

Tawada

Miyamura

et al. 2012

Case Rep Gastroenterol

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Antimitochondrial antibody (AMA) is one of the representative features of primary biliary cirrhosis (PBC). PBC is a female-dominant disease usually presenting intrahepatic bile duct destruction, cholestasis and fibrosis with or without chronic nonsuppurative destructive cholangitis. We presented the case of a 63-year-old man with acute liver failure who had AMA, pronounced alanine aminotransferase elevation and high bilirubinemia. We administered corticosteroids and rescued this patient without liver transplantation. It is well known that some patients within the spectrum of autoimmune liver disease present with characteristics of both PBC and autoimmune hepatitis. Although corticosteroids may be associated with a significant worsening of adverse events in patients with PBC, if acute liver failure in AMA-positive cases is progressive, the administration of corticosteroids has to be considered, as well as the preparation of urgent liver transplantation.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Acute Liver Failure in an Antimitochondrial Antibody-Positive 63-Year-Old Man

Wakamatsu

Tawada

Miyamura

et al. 2012

Case Rep Gastroenterol

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“…Other cases are more sequential in nature. One recent study described two cases of AIH during the course of PBC (3). In each of these cases, the patient had a diagnosis of PBC for 1–2 years before the diagnosis of AIH.…”

Section: Discussionmentioning

confidence: 99%

“…Very little research has been carried out on this population. A recent paper (3) described two such cases. Each involved a patient diagnosed with PBC only to develop AIH 1–2 years later.…”

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confidence: 99%

Development of autoimmune hepatitis in primary biliary cirrhosis

Gossard

Lindor

2007

Liver International

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“…AIH can occasionally have clinical, laboratory, histological, and genetic characteristics identical to those of PBC [10]. Some cases of AIH are difficult to diagnose [10][11][12][13][14]. The incidence of AIH differs in various geographic regions.…”

Section: Introductionmentioning

confidence: 99%

Impact of Aging on Liver Histological Findings of Autoimmune Liver Diseases

et al. 2014

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Our aim is to investigate the recent liver biopsy findings of autoimmune liver diseases at a university hospital located in an urban area of Japan. The study included 259 patients (mean age 56.8 ± 12.5; male/female, 46/213) who underwent a liver biopsy for primary biliary cirrhosis (PBC) or autoimmune hepatitis (AIH). We analyzed their liver biopsy findings according to age and gender. Among 127 PBC patients, Scheuer stages 1, 2, 3, and 4 were 42, 54, 18, and 13, respectively. Among 101 AIH patients, fibrosis stages F1, F2, F3, and F4 were 37, 32, 19, and 13, respectively, and inflammatory activity grades A1, A2, and A3 were 22, 25, and 54, respectively. Among PBC aged ≥65 years, Scheuer stages 1-3 and 4 patients were 27 and 6, respectively. The proportion of Scheuer stage 4 patients in PBC aged ≥65 years tended to be higher than that in PBC aged <65 years (p = 0.0659). Of interest, the proportion of AIH patients with moderate or severe activity (A2 or A3) in males was higher than in females (p = 0.0311). From the point of view of fibrosis stage or inflammatory activity grade of the liver, the proportion of AIH patients aged ≥65 years was similar to that aged <65 years. Although we identified six older cirrhotic patients with AIH, three of them were male. The progression of fibrosis and OPEN ACCESS Diseases 2014, 2 309 inflammatory activity of the liver should be noted when we treat older patients suffering from autoimmune liver diseases. Liver biopsy plays an important role in obtaining accurate information on autoimmune liver diseases in older patients.

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Occurrence of Autoimmune Hepatitis During the Course of Primary Biliary Cirrhosis: Report of Two Cases

Cited by 9 publications

References 12 publications

Acute Liver Failure in an Antimitochondrial Antibody-Positive 63-Year-Old Man

Acute Liver Failure in an Antimitochondrial Antibody-Positive 63-Year-Old Man

Development of autoimmune hepatitis in primary biliary cirrhosis

Impact of Aging on Liver Histological Findings of Autoimmune Liver Diseases

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