Durazzo Marilena, Premoli Alberto, Fagoonee Sharmila, Pellicano Rinaldo
Department of Internal Medicine, University of Turin, Italy.
Dig Dis Sci. 2003 Mar;48(3):423-30. doi: 10.1023/a:1022597210629.
The pattern of some autoimmune hepatitis can be difficult to classify, sometimes due to the overlap of these with primary biliary cirrhosis, primary sclerosing cholangitis and chronic viral hepatitis. The etiology of these variant forms remains unclear. The distinction among the overlap syndromes poses different problems both of prognosis and therapeutic approach. Presently, the utility of the scoring system devised and revised by the International Autoimmune Hepatitis Group regarding these cases is under discussion. Histological examination seems to be an important tool, but often the result does not help in defining a correct diagnosis. To date, the overlap syndromes can be classified at an intermediate level between cholestatic forms of autoimmune hepatitis or hepatic forms of cholestatic syndromes, but it cannot be excluded that the syndromes represent independent disorders.
某些自身免疫性肝炎的模式可能难以分类，有时是因为它们与原发性胆汁性肝硬化、原发性硬化性胆管炎和慢性病毒性肝炎存在重叠。这些变异形式的病因仍不清楚。重叠综合征之间的区分在预后和治疗方法上都带来了不同的问题。目前，国际自身免疫性肝炎小组设计并修订的评分系统在这些病例中的效用正在讨论中。组织学检查似乎是一项重要工具，但结果往往无助于明确正确诊断。迄今为止，重叠综合征可归类于自身免疫性肝炎的胆汁淤积型或胆汁淤积综合征的肝型之间的中间水平，但不能排除这些综合征代表独立疾病的可能性。
