Citation

Salem C, Makhoul E, Murr TEI (2019) Case Report and Review of Literature: An Overlap Syndrome of Autoimmune Hepatitis and Systemic Lupus Erythematous. Clin Med Rev Case Rep 6:249. doi.org/10.23937/2378-3656/1410249

Copyright

© 2019 Salem C, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

CASE REPORT | OPEN ACCESS DOI: 10.23937/2378-3656/1410249

Case Report and Review of Literature: An Overlap Syndrome of Autoimmune Hepatitis and Systemic Lupus Erythematous

Charelle Salem, Elie Makhoul and Tony El Murr*

Department of Internal Medicine, Middle East Institute of Health, Lebanese University, Lebanon

Abstract

Autoimmune Hepatitis (AIH) is a chronic necroinflammatory liver disease of unknown etiology associated with circulating autoantibodies and high serum globulin level. Systemic lupus erythematous (SLE) is a disease of unknown etiology in which tissues and cells are damaged by pathogenic autoantibodies and immune complex, affecting multiple organs including the liver, kidney, and CNS. AIH has been considered to occur infrequently in SLE. We report a 42-year-old female patient with an overlap syndrome involving autoimmune hepatitis (AIH) and systemic lupus erythematous (SLE). The patient presented with jaundice, arthralgias, fatigue, jaundice, mild fever, and abdominal discomfort. Laboratory tests revealed severe liver dysfunction, a positive ANA/anti-dsDNA test. A liver biopsy showed acute hepatitis with severe inflammatory activity that goes with autoimmune hepatitis. The patient satisfied the international criteria for both SLE and AIH. Clinical symptoms and laboratory findings of SLE improved with appropriate treatment by corticosteroids and azathioprine, and remission of the liver disease was achieved as well.