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Uptodate Reference Title
Approach to patients with PBC or PSC and features of AIH
Approach to patients with PBC or PSC and features of AIH
Refer to UpToDate content on the management of patients with autoimmune hepatitis variants and overlap syndromes.
PBC: primary biliary cholangitis; PSC: primary sclerosing cholangitis; UDCA: ursodeoxycholic acid; AIH: autoimmune hepatitis; EASL: European Association for the Study of the Liver; ULN: upper limit of normal. * There are no established definitions of the required degree of elevation of serum transaminases or IgG levels. ALT at least 5×, ULN and IgG at least 2× ULN, as previously suggested as criteria for AIH, may serve as guidelines. ¶ Immunosuppressive treatment is not evidence-based. It can be suggested that initial treatment is given according to guidelines for AIH. Δ The American Association for the Study of Liver Diseases guidelines recommend against UDCA in patients with PSC, whereas the EASL guidelines acknowledge that UDCA is widely used in PSC, although the long-term efficacy remains unproven.
Reproduced from: Boberg KM, Chapman RW, Hirschfield GM. Overlap syndromes: the International Autoimmune Hepatitis Group (IAIHG) position statement on a controversial issue. J Hepatol 2011; 54:374. Illustration used with the permission of Elsevier Inc. All rights reserved.
