Autoimmunity overlaps primary biliary cirrhosis: a not straightforward diagnosis

During the last decades, the diagnostic and clinical approach of acute liver failure has been improved due to a progressive understanding of the disease and better outcomes. The most frequent etiologies are viral hepatitis and acetaminophen intoxication, the former in developing countries and the latter in Europe and the United States. Nevertheless, vascular phenomena, infiltrative diseases, or even autoimmune disorders must also be considered. Systemic lupus erythematosus (SLE) is a multisystem autoimmune disorder usually associated with malar rash, arthralgias, cytopenia, serositis, renal failure, endocarditis, and antiphospholipid syndrome. Liver involvement is normally not a part of the spectrum but observed in up to 60% of SLE patients. Moreover, the co-occurrence of autoimmune hepatitis (AIH) and SLE is considered to be rare, and only few reports have been published so far. In this study, we presented a case report of a patient with this overlap syndrome. (author)