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Characterization of overlap syndrome between primary biliary cirrhosis and autoimmune hepatitis according to antimitochondrial antibodies status.
Alric, Laurent; Thebault, Sophie; Selves, Janik; Peron, Jean-Marie; Mejdoubi, Sanae; Fortenfant, Françoise; Vinel, Jean-Pierre.
Affiliation
  • Alric L; Service de Médecine Interne, Fédération Digestive, Pavillon Dieulafoy, CHU Purpan, Toulouse. ALRIC.L@chu-toulouse.fr
Gastroenterol Clin Biol ; 31(1): 11-6, 2007 Jan.
Article in En | MEDLINE | ID: mdl-17273127
AIMS: Codification of variant forms between Primary Biliary Cirrhosis (PBC) and Autoimmune Hepatitis (AIH) has not been definitively standardized. The aim of this study was to compare among 102 consecutive patients, 2 subsets of overlap syndrome (OS, N=21) with and without antimitochondrial antibody (AMA) to two groups of patients with typical PBC (N=43) or AIH (N=38). METHODS: OS was defined by the presence in the same patient of at least 2 of 3 accepted criteria of PBC and AIH. Twelve patients with OS were AMA negative and 9 were AMA positive. RESULTS: A lower level of alanine transaminase (139+/-48 vs 269+/-154 IU/L, P<0.05) and a trend towards a higher level of alkaline phosphatase or gamma-glutamyl transpeptidase was observed in OS without AMA than in OS with AMA (693+/-200 vs 544+/-124 IU/L; 370+/-66 vs 241+/-77 IU/L, respectively). All AMA-negative patients with OS had antinuclear and/or anti-smooth muscle antibodies. OS without AMA differed from those with AMA in that they had more severe bile duct damage including destructive cholangitis (P<0.05), ductopenia (P<0.05), ductular hyperplasia (P<0.05) and a higher METAVIR fibrosis score (2.5+/-0.3 vs 1.3+/-0.3, P<0.05). The response to therapy was not different between PBC, AIH and OS. CONCLUSIONS: According to the presence of AMA, 2 homogeneous subgroups of patients with overlap syndrome between PBC and AIH may be identified. AMA status affects clinical presentation and liver disease severity of OS.
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Collection: 01-internacional Database: MEDLINE Main subject: Autoantibodies / Mitochondria, Liver / Hepatitis, Autoimmune / Liver Cirrhosis, Biliary Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Gastroenterol Clin Biol Year: 2007 Document type: Article Country of publication: France
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Collection: 01-internacional Database: MEDLINE Main subject: Autoantibodies / Mitochondria, Liver / Hepatitis, Autoimmune / Liver Cirrhosis, Biliary Type of study: Diagnostic_studies / Etiology_studies / Incidence_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Limits: Adult / Female / Humans / Male / Middle aged Language: En Journal: Gastroenterol Clin Biol Year: 2007 Document type: Article Country of publication: France