Vella Francesco Saverio, Simone Barbara, Orlando Pierluigi, Simone Olivia, Antonaci Salvatore
Sezione di Medicina Interna, Dipartimento di Clinica Medica, Immunologia e Malattie Infettive, Università, Bari.
Recenti Prog Med. 2004 Oct;95(10):472-5.
The coexistence of non-organ specific autoantibodies and chronic hepatitis C features raises the dilemma as to whether the pathogenesis is viral or autoimmune and consequently to be treated with interferon or corticosteroids. Two cases with autoimmune characteristics and chronic hepatitis C are reported. We discuss the possibility of classifying this overlap form in three distinct entities: viral disease with an autoimmune epiphenomenon ("false hepatitis C/autoimmune hepatitis overlap syndrome"), viral disease associated to an autoimmune pathogenic component ("true hepatitis C/autoimmune hepatitis overlap syndrome") and false serological anti-HCV positivity in classical autoimmune hepatitis. In our experience the interferon/corticosteroid association was successful.
非器官特异性自身抗体与慢性丙型肝炎特征并存，引发了关于发病机制是病毒源性还是自身免疫性的两难问题，进而涉及到是采用干扰素还是皮质类固醇进行治疗。本文报告了两例具有自身免疫特征的慢性丙型肝炎病例。我们讨论了将这种重叠形式分为三种不同类型的可能性：伴有自身免疫附带现象的病毒性疾病（“假性丙型肝炎/自身免疫性肝炎重叠综合征”）、与自身免疫致病成分相关的病毒性疾病（“真性丙型肝炎/自身免疫性肝炎重叠综合征”）以及经典自身免疫性肝炎中的假血清抗丙型肝炎病毒阳性。根据我们的经验，干扰素/皮质类固醇联合治疗是成功的。
