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Author Credentials

Rutwik Pradeep Sharma

Degree- MBBS

Affiliation-Department of Internal Medicine, Rochester Regional Health/Unity Hospital, Rochester, NY, USA

Mohamed Mohamed Ahmed

Degree- MBBS

Affiliation- Department of Nephrology, University of Maryland Medical System- Shore Regional Health

Ryan Tam

Affiliation- 3rd year Medical Student at Lake Erie College of Osteopathic Medicine

Alexander Kusnik

Degree- MBBS

Affiliation-Department of Internal Medicine, Rochester Regional Health/Unity Hospital, Rochester, NY, USA

Ali Jaan

Degree- MBBS

Affiliation-Department of Internal Medicine, Rochester Regional Health/Rochester General Hospital, Rochester, NY, USA

Ari Chodos

Degree- MD

Affiliation- Rochester Gastroenterology Associates/Rochester Regional Health, Rochester, NY, USA

Naga Rama Krishna Tangirala

Degree- MBBS

Affiliation-Department of Internal Medicine, Rochester Regional Health/Unity Hospital, Rochester, NY, USA

Author ORCID Identifier

0000-0003-3788-7496

Abstract

A 43-year-old female presented with painful obstructive jaundice, a mixed pattern of elevation of liver injury markers and neutrophilic leukocytosis. Evaluation with endoscopic retrograde cholangiopancreatography (ERCP) was unremarkable. The antimitochondrial antibody (AMA) titers were elevated. She was discharged on ursodeoxycholic acid (UDCA) for Primary Biliary Cirrhosis (PBC) but was readmitted for worsening symptoms. The patient's liver biopsy results suggested Overlap syndrome (Primary Biliary Cirrhosis-Autoimmune hepatitis). She was then given corticosteroid therapy concurrently with UDCA after which she improved and remained asymptomatic. In conclusion, we would like to report this atypical presentation of overlap syndrome and hope the medical community learns from our experience by considering overlap syndrome when they see patients without the standard clinical picture of Primary Biliary Cirrhosis or Autoimmune Hepatitis.

Creative Commons License

Creative Commons Attribution-NonCommercial 4.0 International License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

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