| Prevalence of Overlap of Primary Biliary Cirrhosis-Autoimmnune Hepatitis Overlap Syndrome. | |
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MedLine Citation:
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PMID: 21440668 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND & AIMS: The prevalence of and the most appropriate way to diagnose the primary biliary cirrhosis (PBC)-autoimmmune chronic hepatitis (AIH) overlap syndrome are uncertain. We investigated the prevalence of PBC and AIH, and their level of overlap, at a tertiary referral center, along with clinical, biochemical, and serological characteristics. METHODS: We reviewed data from all patients with PBC (n=609) and/or AIH (n=15) examined at the Tufts Medical Center in Boston, MA from January 1, 2000-June 20, 2006. PBC was diagnosed based on 2 of the following 3 results: 6 months of positive results in tests for cholestatic liver enzymes, a positive result in a test for anti-mitochondrial antibodies, or a liver biopsy that indicated PBC. AIH was defined as a level of alanine aminotransferase ≥ 200 U/L (≥5-fold above normal), a liver biopsy that indicated severe interface hepatitis, and levels of immunoglobulin G ≥2-fold that of normal. RESULTS: Only 6 patients with PBC (1%) met the Paris Criteria for the overlap syndrome; if we included 9 patients with PBC who did not meet the Paris criteria, but had results from liver enzyme tests and liver biopsy analyses that indicated improvement following treatment with prednisone, the prevalence was 15 (2.8%); this is at the low end of previously reported prevalence values for overlap of PBC and AIH (2%-20%). CONCLUSIONS: The prevalence of the PBC-AIH overlap syndrome varies among medical centers. We propose that the definition of PBC-AIH overlap syndrome be modified, to include patients with unequivocal responses to prednisone, despite not meeting the Paris Criteria-this would improve treatment of patients. |
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Authors:
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Alan Bonder; Alexandra Retana; Diana M Winston; John Leung; Marshall M Kaplan |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-24 |
Journal Detail:
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Title: Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association Volume: - ISSN: 1542-7714 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-28 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101160775 Medline TA: Clin Gastroenterol Hepatol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Gastroenterology, Tufts Medical Center. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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