Overlap syndromes among autoimmune liver diseases

Figure 1 Overlap syndrome autoimmune hepatitis-primary biliary cirrhosis. A 57-year-old woman presented with elevated γ-GT (2 × ULN) and transaminases (AST 2.5 × ULN, ALT 5.5 × ULN), and normal bilirubin. Serum AMA (1:3840), AMA-M2,ASMA and SLA were positive. Her immunoglobulins showed elevated IgG (23.2 g/L) and IgM (3.3 g/L). A liver biopsy disclosed an interface hepatitis and mild portal fibrosis without evidence of cirrhosis. A: HE, × 20; B: HE, × 40 (Courtesy of Prof. Dr. Müller-Höcker, Munich).