Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver · 2015
The overlap syndrome between primary biliary cirrhosis and primary sclerosing cholangitis.
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Floreani Annarosa, Motta Raffaella, Cazzagon Nora, Franceschet Irene, Roncalli Massimo, Del Ross Teresa, Rosina Floriano, Lleo Ana, Mescoli Claudia, Colloredo Guido, Invernizzi Pietro
Аннотация
BACKGROUND: The overlap syndrome between primary biliary cirrhosis and primary sclerosing cholangitis is an extremely rare condition that has been reported in only six published cases so far.
METHODS: Here we report two cases showing the clinical manifestations of both primary biliary cirrhosis and primary sclerosing cholangitis.
RESULTS: In one case the overlap condition was associated with psoriatric arthritis, and the patient successfully underwent dual treatment with ursodeoxycholic acid and the anti-tumour necrosis factor-alpha agent adalimumab. In the second case, the predominant condition was, initially, an antimitochondrial antibody-negative primary biliary cirrhosis with progressive course towards end-stage liver disease; the patient then developed either antimitochondrial antibody positivity or changes in the biliary tree compatible with primary sclerosing cholangitis.
CONCLUSIONS: These two cases add information on a controversial issue in the literature, and indicate the importance of recognizing a possible overlap syndrome to optimize treatment.
METHODS: Here we report two cases showing the clinical manifestations of both primary biliary cirrhosis and primary sclerosing cholangitis.
RESULTS: In one case the overlap condition was associated with psoriatric arthritis, and the patient successfully underwent dual treatment with ursodeoxycholic acid and the anti-tumour necrosis factor-alpha agent adalimumab. In the second case, the predominant condition was, initially, an antimitochondrial antibody-negative primary biliary cirrhosis with progressive course towards end-stage liver disease; the patient then developed either antimitochondrial antibody positivity or changes in the biliary tree compatible with primary sclerosing cholangitis.
CONCLUSIONS: These two cases add information on a controversial issue in the literature, and indicate the importance of recognizing a possible overlap syndrome to optimize treatment.