自身免疫性肝炎与系统性硬化症：一种新的重叠综合征？
Autoimmune hepatitis and systemic sclerosis: a new overlap syndrome?
作者信息
Marie I, Levesque H, Tranvouez J L, François A, Riachi G, Cailleux N, Courtois H
机构信息
Department of Internal Medicine, Centre Hospitalier Universitaire de Rouen-Boisguillaume, 76031 Rouen Cedex, France.
出版信息
Rheumatology (Oxford). 2001 Jan;40(1):102-6. doi: 10.1093/rheumatology/40.1.102.
OBJECTIVE
We report the cases of two patients with the complete CREST variant (calcinosis, Raynaud's phenomenon, oesophageal dysmotility, sclerodactyly, telangiectasia) of systemic sclerosis (SSc) who developed autoimmune hepatitis.
RESULTS
Our findings suggest that autoimmune hepatitis can be considered to be one of the liver manifestations associated with SSc. Our data also indicate that, because liver involvement may precede skin manifestations, evaluation for SSc is appropriate when autoimmune hepatitis is noted, and that the evaluation should include clinical examination, testing for antinuclear antibodies (especially for anticentromere antibodies) and nailfold capillaroscopy.
CONCLUSIONS
From a practical point of view, our two cases emphasize that suspicion of autoimmune hepatitis in SSc patients presenting with cytolytic hepatitis will help to achieve both accurate diagnosis and optimal management.
目的
我们报告了两例系统性硬化症（SSc）的完全型CREST变异型（钙质沉着、雷诺现象、食管动力障碍、指端硬化、毛细血管扩张）患者发生自身免疫性肝炎的病例。
结果
我们的研究结果表明，自身免疫性肝炎可被视为与SSc相关的肝脏表现之一。我们的数据还表明，由于肝脏受累可能先于皮肤表现出现，因此在发现自身免疫性肝炎时对SSc进行评估是合适的，评估应包括临床检查、抗核抗体检测（尤其是抗着丝点抗体）和甲襞毛细血管镜检查。
结论
从实际角度来看，我们的两例病例强调，对出现细胞溶解性肝炎的SSc患者怀疑有自身免疫性肝炎，将有助于实现准确诊断和优化管理。
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