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目的提高对自身免疫性肝病的认识。方法报道一例自身免疫性肝炎/原发性胆汁性肝硬化重叠综合征误诊为药物性肝炎,并综述相关文献总结其临床表现、诊断、治疗及预后。结果自身免疫性肝病是一组以肝脏病理损害和肝功能异常为主要表现的自身免疫性疾病,可分为自身免疫性肝炎(autoinmmune hepatitis,AIH)和(primary biliary cirrhosis,PBC)及原发性硬化性胆管炎(primary sclerosing cholangitis,PSC)。由于无特异性的临床表现,容易漏诊或误诊为药物性肝炎,诊断主要依靠生化及免疫学检查。AIH/PBC重叠综合征的治疗目前无成熟经验,主要药物包括熊去氧胆酸(UDCA)、糖皮质激素和免疫抑制剂等。结论对于不明原因的肝损害患者应做免疫学筛查。
Objective To raise awareness of autoimmune liver disease. Methods A case of autoimmune hepatitis / primary biliary cirrhosis overlap syndrome was misdiagnosed as drug-induced hepatitis, and the related literature was reviewed to summarize its clinical manifestations, diagnosis, treatment and prognosis. Results Autoimmune liver disease is a group of autoimmune diseases characterized by pathological liver damage and abnormal liver function. It can be divided into autoinmmune hepatitis (AIH) and primary biliary cirrhosis (PBC) and primary Sclerosing cholangitis (PSC). Because of non-specific clinical manifestations, easy to miss or misdiagnosed as drug-induced hepatitis, the diagnosis depends mainly on biochemical and immunological tests. The treatment of AIH / PBC overlap syndrome is currently without mature experience, the main drugs include ursodeoxycholic acid (UDCA), glucocorticoids and immunosuppressive agents. Conclusions Immunologic screening should be performed for patients with unexplained liver damage.