Autoimmune hepatitis-primary biliary cholangitis overlap syndrome complicated by various autoimmune diseases: A case report

Figure 1 Biochemical indicators of patients. A: Dynamic changes in ALT; B: Dynamic changes in AST; C: Dynamic changes in TBA and GGT; D: Dynamic changes in TBIL and DBIL; E: Dynamic changes in serum IgG; F: Dynamic changes in serum IgA and IgM. ALT: Alanine aminotransferase; UDCA: Ursodeoxycholic acid; AST: Aspartate aminotransferase; TBA: Total bile acid; GGT: Glutamyl transpeptidase; TBIL: Total bilirubin; DBIL: Direct bilirubin; IgG: Immunoglobulin G; IgA: Immunoglobulin A; IgM: Immunoglobulin M.

Figure 2 Patient magnetic resonance imaging findings. A: Multiple enlarged lymph nodes in the hepatic hilum at admission; B: The hilar lymphadenopathy resolved after 8 wk of treatment; C: Pancreatic duct dilatation at admission; D: Pancreatic duct dilatation persists after 8 wk of treatment; E: Enlargement of the head of the pancreas at admission; F: Pancreatic head enlargement has been significantly reduced after 8 wk of treatment.

Figure 3 Patient pathological manifestations. A: Plentiful lymphocytes and plasma cells can be seen in a lymph node of the porta hepatis; B: Liver tissue HE staining; scattered punctate necrosis of the liver and infiltration of a large number of inflammatory cells can be seen (HE × 100); C: Liver tissue Masson staining; visible portal fibrosis with fibrous septa formation can be seen (IHC × 100); D: Inflammatory cell infiltration in the portal area of the liver tissue; liver tissue immunoglobulin (IgG) 4-negative (IHC × 200); E: Inflammatory cell infiltration in the portal area of the liver tissue; liver tissue IgG-positive (IHC × 200); F:Pancreatic HE staining; small amount of inflammatory cell infiltration can be seen in the glands of the pancreas (HE × 100); G: Pancreatic IgG4-negative (IHC × 200).

Figure 4 Endoscopic ultrasound findings of patients. A: Endoscopic ultrasonography of hepatic lymph node; B: Uncinate process of the pancreas; C: Pancreatic lymph node; D: Pancreatic lymph node.