naa a22 4500 510813739 CHVBK 20180411083455.0 cr unu---uuuuu 180411e20131201xx s 000 0 eng 10.1007/s12328-013-0423-9 doi (NATIONALLICENCE)springer-10.1007/s12328-013-0423-9 A case of primary biliary cirrhosis and autoimmune hepatitis overlap showing acute presentation and transient seropositivity for immunoglobulin G and anti-nuclear antibody [Elektronische Daten] [Keiichi Fujiwara, Katsushi Seza, Yoshihiro Fukuda, Masayuki Nakano, Osamu Yokosuka] Autoimmune hepatitis (AIH) is generally regarded as a clinically and histologically "chronic” hepatitis. It often shows acute presentation like acute hepatitis without typical clinicopathological features of AIH, especially in a case of overlap with primary biliary cirrhosis (PBC). A 52-year-old man showed mild liver dysfunction for the first time at an annual medical check. Two months later, he showed jaundice, and laboratory tests revealed elevation of liver enzymes, hyperbilirubinemia and prolonged prothrombin time activity like acute liver failure. Anti-mitochondrial antibody was positive and other viral and autoimmune markers were negative. His liver function tests improved upon treatment with ursodeoxycholic acid and maximum intravenous glycyrrhizin (IVGL), but liver dysfunction was again exacerbated after the gradual reduction of IVGL. He showed transient elevation of immunoglobulin G (IgG) and anti-nuclear antibody (ANA) at only one point, and liver histology was compatible with PBC and AIH overlap syndrome. Corticosteroid was administered and his liver function tests returned to normal. It is important for the diagnosis of acute onset AIH to monitor IgG level and ANA titer, especially in patients without IgG and ANA elevations at first appearance. Springer Japan, 2013 Primary biliary cirrhosis nationallicence Autoimmune hepatitis nationallicence Anti-nuclear antibody nationallicence Immunoglobulin G nationallicence Fujiwara Keiichi Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8670, Chiba, Japan aut Seza Katsushi Department of Gastroenterology, Seikeikai Chiba Medical Center, 260-0842, Chiba, Japan aut Fukuda Yoshihiro Department of Gastroenterology, Seikeikai Chiba Medical Center, 260-0842, Chiba, Japan aut Nakano Masayuki Division of Pathology, Ofuna Chuo Hospital, 247-0056, Kamakura, Japan aut Yokosuka Osamu Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8670, Chiba, Japan aut Clinical Journal of Gastroenterology Springer Japan 6/6(2013-12-01), 465-469 1865-7257 6:6<465 2013 6 12328 https://doi.org/10.1007/s12328-013-0423-9 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12328-013-0423-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Fujiwara Keiichi Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8670, Chiba, Japan aut NATIONALLICENCE 700 1- Seza Katsushi Department of Gastroenterology, Seikeikai Chiba Medical Center, 260-0842, Chiba, Japan aut NATIONALLICENCE 700 1- Fukuda Yoshihiro Department of Gastroenterology, Seikeikai Chiba Medical Center, 260-0842, Chiba, Japan aut NATIONALLICENCE 700 1- Nakano Masayuki Division of Pathology, Ofuna Chuo Hospital, 247-0056, Kamakura, Japan aut NATIONALLICENCE 700 1- Yokosuka Osamu Department of Gastroenterology and Nephrology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, 260-8670, Chiba, Japan aut NATIONALLICENCE 773 0- Clinical Journal of Gastroenterology Springer Japan 6/6(2013-12-01), 465-469 1865-7257 6:6<465 2013 6 12328 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer