Difficulties in differential diagnosis of inflammatory bowel diseases in patient with overlapping autoimmune hepatitis and primary sclerosing cholangitis

2021 ◽  
Vol 1 (6) ◽  
pp. 26-30
Author(s):  
T. S. Krolevets ◽  
M. A. Livzan ◽  
M. I. Plinder
Keyword(s):  
Autoimmune Hepatitis ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Accurate Diagnosis ◽  
Eosinophilic Colitis ◽  
Morphological Picture ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Autoimmune Hepatitis Type 1

The article presents a clinical case of cross-syndrome of autoimmune hepatitis type 1 with primary sclerosing cholangitis. The main symptoms, laboratory and instrumental criteria of these diseases are discussed. Detection of specific antibodies is necessary for an accurate diagnosis. Interpretation of changes in the colon obtained by stepwise biopsy requires special attention. The described morphological picture does not allow to make an accurate diagnosis, it can be regarded as initial manifestations of Crohn's disease, microscopic or eosinophilic colitis, signs of worm-parasitic invasion. An example of a differential diagnostic search in such a situation is discussed.

scholarly journals Chronic recurrent multifocal osteomyelitis and primary sclerosing cholangitis with type 1 autoimmune hepatitis in a child with ulcerative colitis: a case report

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Hon Yan Ng ◽  
Orlee R. Guttman ◽  
Lori B. Tucker
Keyword(s):  
Autoimmune Hepatitis ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Chronic Recurrent Multifocal Osteomyelitis ◽  
Unique Case ◽  
Case Presentation ◽  
Multifocal Osteomyelitis ◽  
Inflammatory Bowel ◽  
Bone Inflammation

Abstract Background Chronic Recurrent Multifocal Osteomyelitis (CRMO) is a condition characterized by sterile bone inflammation, usually occurring in childhood. Although the etiology remains unclear, this condition has been associated with inflammatory bowel disease (IBD). Primary sclerosing cholangitis (PSC) and Autoimmune Hepatitis (AIH) are also uncommon pediatric conditions with a known association with IBD. Case presentation We present a unique case of a pediatric patient with an initial diagnosis of CRMO, with subsequent diagnosis of autoimmune hepatitis and PSC overlap, and eventually IBD. Conclusions Patients with CRMO may also develop PSC in addition to IBD, further highlighting the importance of IBD pathophysiology in both conditions. Clinical screening of associated gastrointestinal findings may be of value in patients with CRMO.

Su1984 CLINICAL PRESENTATION AND OUTCOMES OF PRIMARY SCLEROSING CHOLANGITIS AND AUTOIMMUNE HEPATITIS IN INFLAMMATORY BOWEL DISEASE

2020 ◽  
Vol 158 (6) ◽  
pp. S-732-S-733
Author(s):  
Camilla A. Martins ◽  
Ana Elisa R. Caon ◽  
Marilia G. Cruz ◽  
Luísa L. Barros ◽  
Alexandre Carlos ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Autoimmune Hepatitis ◽  
Primary Sclerosing Cholangitis ◽  
Bowel Disease ◽  
Sclerosing Cholangitis ◽  
Clinical Presentation ◽  
Inflammatory Bowel

scholarly journals Effects of Vedolizumab in Patients With Primary Sclerosing Cholangitis and Inflammatory Bowel Diseases

2020 ◽  
Vol 18 (1) ◽  
pp. 179-187.e6 ◽  
Author(s):  
Kate D. Lynch ◽  
Roger W. Chapman ◽  
Satish Keshav ◽  
Aldo J. Montano-Loza ◽  
Andrew L. Mason ◽  
...  
Keyword(s):  
Primary Sclerosing Cholangitis ◽  
Inflammatory Bowel Diseases ◽  
Sclerosing Cholangitis ◽  
Bowel Diseases ◽  
Inflammatory Bowel

scholarly journals In autoimmune hepatitis type 1 or the autoimmune hepatitis-sclerosing cholangitis variant defective regulatory T-cell responsiveness to IL-2 results in low IL-10 production and impaired suppression

Hepatology ◽  
2015 ◽  
Vol 62 (3) ◽  
pp. 863-875 ◽  
Author(s):  
Rodrigo Liberal ◽  
Charlotte R. Grant ◽  
Beth S. Holder ◽  
John Cardone ◽  
Marc Martinez-Llordella ◽  
...  
Keyword(s):  
T Cell ◽  
Autoimmune Hepatitis ◽  
Regulatory T Cell ◽  
Sclerosing Cholangitis ◽  
Autoimmune Hepatitis Type 1

Different immunogenetic background in autoimmune hepatitis type 1, type 2 and autoimmune sclerosing cholangitis

2002 ◽  
Vol 36 ◽  
pp. 156 ◽  
Author(s):  
James A. Underhill ◽  
Yun Ma ◽  
Dimitrios P. Bogdanos ◽  
Paul Cheeseman ◽  
Giorgina Mieli-Vergani ◽  
...  
Keyword(s):  
Autoimmune Hepatitis ◽  
Sclerosing Cholangitis ◽  
Autoimmune Sclerosing Cholangitis ◽  
Autoimmune Hepatitis Type 1

Autoimmune Hepatitis/Overlap Syndromes

2018 ◽  
Author(s):  
Albert J Czaja
Keyword(s):  
Autoimmune Hepatitis ◽  
Primary Sclerosing Cholangitis ◽  
Sclerosing Cholangitis ◽  
Clinical Evidence ◽  
Calcineurin Inhibitors ◽  
Primary Biliary Cholangitis ◽  
Histological Findings ◽  
Overlap Syndromes ◽  
Inflammatory Bowel ◽  
Lymphoplasmacytic Infiltration

When autoimmune hepatitis has features of primary biliary cholangitis or primary sclerosing cholangitis, these mixed clinical phenotypes constitute overlap syndromes. Diagnostic criteria have been promulgated, but clinical judgement and liver tissue examination remain cornerstones of diagnosis. Cholestatic laboratory and histological findings, concurrent inflammatory bowel disease, or non-response to conventional corticosteroid therapy compel practitioners to consider overlap in patients with autoimmune hepatitis. Laboratory indices of marked liver inflammation and histological findings of moderate to severe interface hepatitis, especially with lymphoplasmacytic infiltration, also warrant consideration of overlap in patients with primary biliary cholangitis or primary sclerosing cholangitits. Treatment recommendations to date have been based on weak clinical evidence, and disease management should be individualized and guided by the predominant disease component. Prednisone or prednisolone in combination with azathioprine has been used in patients with predominantly autoimmune hepatitis, whereas low dose ursodeoxycholic acid in conjunction with corticosteroid-based regimens has been recommended in syndromes with predominately cholestatic disease. All treatments have been variably effective, especially in patients with overlapping features of primary sclerosing cholangitis. Mycophenolate mofetil and calcineurin inhibitors have been used as salvage therapies in limited experiences, and liver transplantation has been associated with graft and overall survivals similar to those of the classical unmixed diseases.  This review contains 6 figures, 7 tables and 50 references Keywords: autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis, overlap, cholestatic laboratory and histological features

Sign in / Sign up

Export Citation Format

Share Document