ABSTRACT
El termino "Overlap" describe entidades que comparten características de hepatitis autoinmune y cirrosis biliar primaria o colangítis esclerosante primaria. Se presenta el caso de una paciente mujer, adulta mayor, sin antecedentes de consumo de alcohol ni medicamentos o sustancias hepatotóxicas, con estudios serológicos para hepatitis viral negativos. Clínicamente con signos de hepatopatía crónica. La paciente presenta características clínicas, serológicas, inmunológicas e histológicas mixtas entre Hepatitis Autoinmuney Cirrosis Biliar Primaria, postulándose un síndrome de "sobreposición" u overlap.
The term"overlap sindrome" has been introduced to the field of hepatology to describe variant forms of autoimmune hepatitis (AIH) which present with characteristics of AIH and primary biliary cirrhosis (PBC) or primary sclerosing cholangitis (PSC). We present a case of an elderly female, without past medical history of alcohol, medication or hepatotoxic substances intake, with negative serology studies for viral hepatitis. Clinically with signs of chronic hepatophaty. The patient presents mixed clinical, serologic, immunologic and histologic features of Autoimmune Hepatitis and Primary Biliary Cirrhosis. We postulate this is a variant or overlap syndrome.
Subject(s)
Liver Cirrhosis, BiliaryABSTRACT
Se reporta el caso de una mujer de 53 años de edad, que acude a emergencia con una historia de 1 semana de baja de peso, dolor epigástrico, y vómitos severos. El examen físico reveló un abdomen doloroso a la palpación, tremor fino de las manos e hiperreflexia. Se realizaron varios estudios, incluidos ecografía abdominal y endoscopía digestiva alta Después de la admisión al servicio de hospitalización, los análisis de hormonas tiroideas mostraron niveles elevados de tiroxina y triiodotironina, y tirotropina suprimida. Se inició tratamiento con propiltiouracilo y Propanolol, presentando mejoría clínica. La paciente fue dada de alta sin molestias.
We report a 53-year-old woman with a 1-week history of weight loss, epigastrio pain, nausea and severe vomiting that carne to the emergeney room. Physical examination showed a painful abdomen on palpation, fine tremor of her hands and reflexes were brisk. The patient underwent an extensive work-up, including an abdominal ultrasound and endoscopy. After admission, thyroid hormones showed elevated levels of free thyroxine and triiodothyronine while thyrotropin was suppressed. Therapy was begun with propiltiouracil and propanolol which decrease her clinical symptoms. The patient was discharged from the hospital without any complaint.