Concurrent autoimmune diseases in patients with autoimmune hepatitis.
BACKGROUND
Although the pathomechanisms of autoimmune diseases in various organs remain unresolved, an accumulation of autoimmune diseases in individual patients has been observed. An overlap of autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) or primary sclerosing cirrhosis has been well documented. However, the overlap of autoimmune diseases other than PBC or PSC has not yet been investigated in a large cohort.


OBJECTIVE
The goal of our analysis was to investigate the incidence of concurrent autoimmune diseases in patients with AIH.


METHODS
We analyzed our cohort of 278 patients with AIH for concurrent autoimmune diseases.


RESULTS
A total of 111 patients (40%) were diagnosed with additional autoimmune diseases. Besides overlap syndromes for PBC and PSC, autoimmune thyroiditis was the most common concurrent disease (28 patients, 10%). Other concurrent autoimmune diseases comprised vitiligo (5 patients), rheumatoid arthritis (5 patients), Sjogren syndrome (4 patients), ulcerative colitis (4 patients), conjunctivitis (4 patients), celiac disease (3 patients), systemic lupus erythematodes (2 patients), type I diabetes (2 patients), multiple sclerosis (2 patients), polymyalgia rheumatica (2 patients), and urticaria (2 patients). One patient each was diagnosed with Crohn's disease, autoimmune gastritis, collagenous colitis, hypophysitis, and sarcoidosis. Investigating 100 patients with polyglandular syndrome and autoimmune thyroid disease for the occurrence of autoantibodies associated with AIH, we identified AIH-associated antibodies only in 1 patient.


CONCLUSIONS
Concurrent autoimmune diseases are common in patients with AIH and mirror the full range of known autoimmune diseases. Therefore, an extended diagnostic screening for accumulating autoimmune diseases, especially autoimmune thyroiditis, seems reasonable in patients with AIH.
Teufel
Andreas
A
Department of Medicine I, Johannes Gutenberg University, Mainz, Germany.
Weinmann
Arndt
A
Kahaly
George J
GJ
Centner
Catherine
C
Piendl
Anja
A
Wörns
Marcus
M
Lohse
Ansgar W
AW
Galle
Peter R
PR
Kanzler
Stephan
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D002648:Child; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000150:complications* / Q000453:epidemiology / Q000276:immunology; D008297:Male; D008875:Middle Aged; D013967:Thyroiditis, Autoimmune / Q000150:complications / Q000453:epidemiology / Q000276:immunology; D055815:Young Adult
D001323:Autoantibodies