Liver Failure in Autoimmune Hepatitis Overlap Syndrome With Primary Biliary Cholangitis: A Case Report

Autoimmune hepatitis (AIH) is a complex and long-term liver condition, primarily affecting women, and is marked by high levels of serum gamma globulins, the presence of circulating autoantibodies, and a genetic association. The disease can manifest in a variety of ways, ranging from mild or no symptoms to severe acute liver inflammation. AIH is often associated with other autoimmune disorders, such as primary biliary cholangitis (PBC) and autoimmune thyroiditis. The progression of the disease can lead to cirrhosis or liver failure if not treated with immunosuppressive therapy. Overlap syndromes, such as AIH with PBC, further complicate both diagnosis and management due to the lack of standardized treatment protocols. The rarity of AIH and the absence of large-scale, randomized clinical trials significantly limit current treatment strategies, underscoring the need for ongoing research to improve therapeutic approaches. We report on a 54-year-old female patient who was admitted with acute hepatitis that rapidly progressed to liver failure. After ruling out other causes, corticosteroid treatment was started based on a suspected diagnosis of AIH. Liver biopsy results supported the diagnosis of an overlap syndrome involving AIH and PBC.