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Autoimmune hepatitis (AIH), primary biliary cirrhosis and primary sclerosing cholangitis (PSC) is considered to have different signs of autoimmune liver disease, but may overlap syndrome (simultaneous or successive There were 2 kinds of diseases). Differential overlap syndrome is important because such patients may need additional treatment and the prognosis is different.
Canadian scholars with magnetic resonance cholangiography (MRC) check to clear tube adult AIH patients the incidence of abnormal bold, and to assess the risk factors associated with its occurrence. Research shows, adult AIH patients receiving MRC by histological examination and diagnosis of hepatic sclerosing cholangitis, but may not be appropriate obvious clinical manifestations, therefore, sclerosing cholangitis and AIH overlap may be higher than the prevalence of the original understanding of prevalence. The research paper published in the "liver" [Hepatology 2008,47 (3): 949] on.
Researchers from Toronto, a tertiary medical center included 204 cases of AIH patients, 79 patients (female 63, mean age 37.3 years) received MRC examination. In these 79 patients, 49% of AIH patients diagnosed, the rest were suspected AIH. The researchers also retrospectively analyzed 29 patients with liver pathology. Two independent radiologists to analyze all of the MRC image will be divided into positive sclerosing cholangitis there may exist or not exist three categories.
The results showed that, in the MRC screening, 8 cases of patients diagnosed as AIH are positive or there may be evidence of sclerosing cholangitis. Two radiologists good consistency between observations [kappa (Kappa) 0.87]. Sclerosing cholangitis and AIH overlap incidence and younger [(24.3 11.9) years, P = 0.024], higher baseline alkaline phosphatase [(196.4 98.3) U / L; P = 0.037], the MRC check During the high bilirubin levels [(45.8 37.2) mol / L; P = 0.032], and lobular inflammatory activity of the initial biopsy was significantly associated with higher, but alkaline phosphatase and aspartate aminotransferase ratio , to receive MRC onset AIH inspection time, unrelated to early liver pathology.
Portland Oregon Health and Science University, Associate Professor, like the door: The small sample results show that very few mergers PSC, AIH patients can be identified by MRC. More importantly, the results show that higher levels of alkaline phosphatase and bilirubin in patients with AIH-PSC AIH high risk of overlap. The presence of the PSC of the treatment and prognosis, so for those receiving treatment for AIH measures or continuing the index was still significantly higher in the AIH patients, clinicians should consider using MRC check to clear possible sclerosing cholangitis.



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