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The overlap syndrome between primary biliary cirrhosis and primary sclerosing cholangitis
Annarosa Floreani1, Raffaella Motta2, Nora Cazzagon1
1Department of Surgery, Oncology and Gastroenterology, University of Padova, Italy.
Background:
The overlap syndrome between primary biliary cirrhosis and primary sclerosing cholangitis is an extremely rare condition that has been reported in only six published cases so far.
Methods:
Here we report two cases showing the clinical manifestations of both primary biliary cirrhosis and primary sclerosing cholangitis.
Results:
In one case the overlap condition was associated with psoriatric arthritis, and the patient successfully underwent dual treatment with ursodeoxycholic acid and the anti-tumour necrosis factor-alpha agent adalimumab. In the second case, the predominant condition was, initially, an antimitochondrial antibody-negative primary biliary cirrhosis with progressive course towards end-stage liver disease; the patient then developed either antimitochondrial antibody positivity or changes in the biliary tree compatible with primary sclerosing cholangitis.
Conclusions:
These two cases add information on a controversial issue in the literature, and indicate the importance of recognizing a possible overlap syndrome to optimize treatment.
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