PBC/AIH Crossover AND switch to the other..............

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http://www3.interscience.wiley.com/journal/118965744/abstract?CRETRY=1 & SRETRY=0

Development of autoimmune hepatitis in the setting of long-standing primary

biliary cirrhosis

Angulo, M.D. a , Omer El-Amin, M.D. a , Herschel A. Carpenter, M.D. b ,

D. Lindor, M.D. a

a Division of Gastroenterology and Hepatology, Mayo Clinic and Foundation,

Rochester, Minnesota, USA b Department of Laboratory Medicine and Pathology,

Mayo Clinic and Foundation, Rochester, Minnesota USA

Reprint requests and correspondence: D. Lindor, M.D., Division of

Gastoenterology and Hepatology, Mayo Clinic and Foundation, 200 First Street

Southwest, Rochester, MN 55905

Copyright 2001 by Am. Coll. of Gastroenterology

ABSTRACT

Primary biliary cirrhosis and autoimmune hepatitis, the most common autoimmune

liver diseases in adults, are frequently easily differentiated by a combination

of clinical, biochemical, and histological features along with the presence of

highly sensitive and characteristic serum autoantibodies. Patients presenting

with " overlapping " features of both conditions simultaneously are not uncommon.

(READ THIS *** This I didn't know before , that it could change from one to the

other!!!) However, patients who switch over time from one disease to another

have remained largely unrecognized. We report here two cases from the spectrum

of autoimmune liver disease, patients who had well-defined primary biliary

cirrhosis for a number of years and then developed the classic picture of

superimposed autoimmune hepatitis. The importance of its recognition and the

appropriate management modifications are discussed.

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