Masks of autoimmune hepatitis. Clinical observations

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Masks of autoimmune hepatitis. Clinical observations

Journal Title: Сучасна гастроентерологія - Year 2019, Vol 0, Issue 3

Abstract

Autoimmune hepatitis is a diagnosis of exclusion. Based on literature data, a third of patients are diagnosed with other autoimmune diseases, which are combined with AIH, which aggravates the severity of the disease and makes it difficult to diagnose. The AIH should be considered in case of any patient with acute or chronic liver disease, especially in the presence of hypergammaglobulinemia, and also if the patient has manifestations of other autoimmune diseases. The article presents clinical observations of patients with autoimmune liver disease. The development and course of the disease had masks, because it combined with other autoimmune diseases, such as vitiligo and primary biliary cholangitis. A feature of these cases is an atypical clinical manifestation of the disease. A long period of clinical well-being did not allow suspecting the presence of a pathology, which resulted in the presence of fibrosis and steatosis, but the presence of anti-LC1 antibodies allowed to diagnose AIH-2 and quickly assigning of pathogenetic therapy in the first clinical observation. The diagnosis was complicated by taking a biological active additives and the presence of vitiligo. The question of whether overlap-syndromes are independent diseases or are a variant of the AIH course, nowadays is still remain controversial, since the clinical manifestations of hepatitis are obligatory present in any of the variants of the overlap-syndrome. The data of the anamnesis and laboratory investigations of the second patient, which was under our supervision, showed the presence of pathology of the biliary tract and only detailed examination allowed us to confirm the presence of overlap-syndrome. Diagnosis of AIH and combined syndromes is a difficult task in the doctor’s clinical practice and requires a multidisciplinary approach. For this category of patients thorough examination and standardization of diagnostic criteria is necessary, because it will help in prompt diagnosis and adequate treatment of such severe patients.

Authors and Affiliations

L. V. Zhuravlyova, O. I. Tsivenko, О. V. Lakhno

Keywords

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EP ID EP615679
DOI 10.30978/MG-2019-3-50
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