Autoimmune hepatitis and systemic sclerosis: a new overlap syndrome?
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.
Marie
I
I
Department of Internal Medicine, Centre Hospitalier Universitaire de Rouen-Boisguillaume, 76031 Rouen Cedex, France.
Levesque
H
H
Tranvouez
J L
JL
François
A
A
Riachi
G
G
Cailleux
N
N
Courtois
H
H
D000368:Aged; D017675:CREST Syndrome / Q000150:complications*; D003937:Diagnosis, Differential; D005260:Female; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008875:Middle Aged