[A case of primary biliary cholangitis whose pathology changed during autoimmune hepatitis].

A 70-year-old female patient was diagnosed with autoimmune hepatitis (AIH) at the age of 58 years based on antinuclear antibodies (1:1280) and liver biopsy findings. She received prednisolone (PSL). Over time, elevated levels of liver enzymes and alkaline phosphatase were observed, and 12 years later, a repeat liver biopsy revealed no signs of AIH but showed characteristics of primary biliary cholangitis (PBC). After reducing the PSL dose and starting ursodeoxycholic acid and pemafibrate, the blood test results improved. A liver biopsy is useful if a change in the condition is suspected, even in a patient undergoing follow-up for AIH or PBC.