抗-HAV-IgM阳性的自身免疫性肝炎-原发性胆汁性胆管炎重叠综合征1例报告

何艳莎; 刘华宝; 宋翊; 陈新瑜; 饶春燕

doi:10.3969/j.issn.1001-5256.2022.04.025

抗-HAV-IgM阳性的自身免疫性肝炎-原发性胆汁性胆管炎重叠综合征1例报告

DOI: 10.3969/j.issn.1001-5256.2022.04.025

重庆市中医院肝病科，重庆 400000

基金项目:

重大疑难疾病(肝纤维化)中西医临床协作试点项目 (Department of Medicine, State Adminstration of Traditional Chinese Medicine(2018)No.3);

重庆市技术创新与应用发展专项重点项目 (cstc2019jscx-dxwtBX0023);

重庆市自然科学基金 (cstc2020jcyj-msxmX0630);

重庆卫生健康委员会、重庆市科学技术局联合中医药科研项目 (2019ZY3202)

化理学声明：本例报告已获得患者知情同意。

利益冲突声明：所有作者均声明不存在利益冲突。

作者贡献声明：何艳莎、饶春燕负责课题设计，资料分析，撰写论文；何艳莎参与收集数据，修改论文；宋翊、陈新瑜、刘华宝负责拟定写作思路，指导撰写文章并最后定稿。

详细信息

通信作者:
饶春燕，chunyanrao@126.com

计量
- 文章访问数: 489
- HTML全文浏览量: 150
- PDF下载量: 51
- 被引次数: 0
出版历程
- 收稿日期: 2021-07-27
- 出版日期: 2022-04-20

A case of anti-HAV-IgM-positive AIH-PBC overlap syndrome

Department of Hepatology, Chongqing Traditional Chinese Medicine Hospital, Chongqing 400000, China

Research funding:

Pilot Project of Clinical Coopetation of Traditional Chinese and Western Medicine in Major Difficult Diseases(Liver Fibrosis) (Department of Medicine, State Adminstration of Traditional Chinese Medicine(2018)No.3);

Special Key Projects of Technological innovation and Application Development in Chongqing (cstc2019jscx-dxwtBX0023);

Natural Science Foundation of Chongqing, China (cstc2020jcyj-msxmX0630);

Chongqing Medical Scientific Research Project(Joint Project of Chongqing Health Commission and Science and Technology Bureau) (2019ZY3202)

More Information

Corresponding author: RAO Chunyan, chunyanrao@126.com(ORCID: 0000-0002-3580-9369)

摘要

- 甲型肝炎抗体 /
- 肝炎，自身免疫性 /
- 原发性胆汁性胆管炎
- Hepatitis A Antibodies /
- Hepatitis, Autoimmune /
- Primary Biliary Cholangitis

HTML全文

图 1 肝穿刺病理结果(HE染色，×200)

注：a，汇管区明显扩大，较多淋巴细胞、中性粒细胞、浆细胞浸润，中重度界面炎，可见小胆管损伤及桥接坏死；b，胆管上皮CK19阳性，可见轻-中度细胆管增生；c，IgG阳性，25个/HPF。

Figure 1. Pathological results of liver puncture (hematoxylin-eosin staining, × 200)

下载: 全尺寸图片幻灯片

参考文献(13)

[1]	WU MC, LI MD. Practice of hepatology[M]. Beijing: People's Medical Publishing House, 2011: 228. 吴孟超, 李梦东. 实用肝脏病学[M]. 北京: 人民卫生出版社, 2011: 228.
[2]	RUST C, BEUERS U. Overlap syndromes among autoimmune liver diseases[J]. World J Gastroenterol, 2008, 14(21): 3368-3373. DOI: 10.3748/wjg.14.3368.
[3]	BUNCHORNTAVAKUL C, REDDY KR. Diagnosis and management of overlap syndromes[J]. Clin Liver Dis, 2015, 19(1): 81-97. DOI: 10.1016/j.cld.2014.09.005.
[4]	SUN CY, MA X. An excerpt of EASL Clinical Practice Guidelines: The diagnosis and management of patients with primary cholangitis(2017)[J]. J Clin Hepatol, 2017, 33(10): 1888-1894. DOI: 10.3969/j.issn.1001-5256.2017.10.008. 孙春燕, 马雄. 《2017年欧洲肝病学会临床实践指南: 原发性胆汁性胆管炎的诊断和管理》摘译[J]. 临床肝胆病杂志, 2017, 33(10): 1888-1894. DOI: 10.3969/j.issn.1001-5256.2017.10.008.
[5]	TRAM J, LE BACCON-SOLLIER P, BOLLORÉ K, et al. RNA testing for the diagnosis of acute hepatitis A during the 2017 outbreak in France[J]. J Viral Hepat, 2020, 27(5): 540-543. DOI: 10.1111/jvh.13255.
[6]	LANDRY ML. Immunoglobulin M for acute infection: True or false?[J]. Clin Vaccine Immunol, 2016, 23(7): 540-545. DOI: 10.1128/CVI.00211-16.
[7]	DESBOIS D, GRANGEOT-KEROS L, ROQUEBERT B, et al. Usefulness of specific IgG avidity for diagnosis of hepatitis A infection[J]. Gastroenterol Clin Biol, 2005, 29(5): 573-576. DOI: 10.1016/s0399-8320(05)82132-3.
[8]	CHAZOUILLÈRES O, WENDUM D, SERFATY L, et al. Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: Clinical features and response to therapy[J]. Hepatology, 1998, 28(2): 296-301. DOI: 10.1002/hep.510280203.
[9]	European Association for the Study of the Liver. EASL clinical practice guidelines: Management of cholestatic liver diseases[J]. J Hepatol, 2009, 51(2): 237-267. DOI: 10.1016/j.jhep.2009.04.009.
[10]	TANEJA S, KUMAR P, MITRA S, et al. Acute exacerbation to autoimmune hepatitis mimicking acute viral hepatitis-a case series and review of literature[J]. J Clin Exp Hepatol, 2018, 8(1): 98-103. DOI: 10.1016/j.jceh.2017.08.005.
[11]	ABE K, KANNO Y, OKAI K, et al. Centrilobular necrosis in acute presentation of Japanese patients with type 1 autoimmune hepatitis[J]. World J Hepatol, 2012, 4(9): 262-267. DOI: 10.4254/wjh.v4.i9.262.
[12]	OZASLAN E, EFE C, HEURGUÉ-BERLOT A, et al. Factors associated with response to therapy and outcome of patients with primary biliary cirrhosis with features of autoimmune hepatitis[J]. Clin Gastroenterol Hepatol, 2014, 12(5): 863-869. DOI: 10.1016/j.cgh.2013.09.021.
[13]	HEURGUÉ A, VITRY F, DIEBOLD MD, et al. Overlap syndrome of primary biliary cirrhosis and autoimmune hepatitis: A retrospective study of 115 cases of autoimmune liver disease[J]. Gastroenterol Clin Biol, 2007, 31(1): 17-25. DOI: 10.1016/s0399-8320(07)89323-7.