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. 2014 Feb 10;3(1):2-5.
doi: 10.1002/cld.294. eCollection 2014 Jan.

Overlap syndromes

Albert J Czaja  1
Affiliations

Overlap syndromes

Albert J Czaja. Clin Liver Dis (Hoboken). .
No abstract available

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Figures

Figure 1
Figure 1
Porous diagnostic boundaries and commonly shared features of AIH, PBC, and PSC. ANAs and abnormalities in the serum levels of AP, GGT, and gamma‐globulin are among the laboratory changes that are commonly shared between the diseases. Similarly, interface hepatitis, plasma cell infiltration, and cholangitis are frequently shared histological changes. PBC and PSC have highly disease‐specific features that rarely overlap.
Figure 2
Figure 2
Diagnostic algorithm for the overlap syndromes. Patients with AIH, PBC, or PSC who have atypical hepatitic or cholestatic laboratory or histologic findings have concurrent inflammatory bowel disease, or do not respond to conventional treatments should undergo ERC or MRC. The cholangiographic findings can then be used in conjunction with the presence or absence of AMAs to distinguish between AIH and PBC (AIH‐PBC), AIH and an indeterminate cholestatic disease (AIH–indeterminate cholestasis), PBC and PSC (PBC‐PSC), and AIH and PSC (AIH‐PSC) in patients with the overlap syndromes. The clinical findings can also be used to distinguish the predominant disease component in each overlap syndrome. The Paris criteria tend to define a syndrome with equivalent AIH and PBC components (AIH = PBC). The other overlap syndromes of AIH and PBC can be either AIH‐predominant (AIH > PBC) or PBC‐predominant (PBC > AIH). Similarly, patients with the overlap syndrome of AIH and PSC (AIH‐PSC) can be either AIH‐predominant (AIH > PSC) or PSC‐predominant (PSC > AIH).
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References

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