Details

Autor(en) / Beteiligte

• Ofosu, Andrew
• Dwivedi, Ankit
• Dadana, Sriharsha
• Gaduputi, Vinaya

Titel

Overlap Syndrome: A Serological and Histological Dilemma: 2339

Ist Teil von

• The American journal of gastroenterology, 2018-10, Vol.113 (Supplement), p.S1313-S1313

Ort / Verlag

New York: Wolters Kluwer Health Medical Research, Lippincott Williams & Wilkins

Erscheinungsjahr

2018

Beschreibungen/Notizen

• A 63 year old woman with history of diabetes mellitus presented to the hospital with generalized weakness of 2 weeks duration.Patient admitted to taking Chinese herbal supplements for past 3 months. Physical examination was remarkable for scleral icterus with no other signs of chronic liver disease. Lab tests were remarkable for aspartate aminotransferase of 184 U/L,alanine aminotransferase of 141 U/L,alkaline phosphatase ot 1006 U/L,total bilirubin of 5.1mg/dL,direct bilirubin of 3.7 mg/dLand INR-I.4.U!trasound of the abdomen showed a common bile duct (CBD) of 6mm size without intraluminal filling defects.Serologies for Hepatitis A,B and C were negative.Further workup revealed positive anti-mitochondrial antibody, positive anti-smooth muscle antibody and negative anti-liver kidney microsomal antibody.Magnetic resonance cholangiopancreatography showed signal dropout in proximal CBD suggestive of possible stricture but endoscopic retrograde cholangiopancreatography showed normal CBD.Liver Biopsy showed circumferential interface hepatitis present in all portal tracts thus making the histological diagnosis more consistent with autoimmune hepatitis with PBC.Patient was managed with ursodiol with steroids.