title: Autoimmune hepatitis/primary biliary cirrhosis overlap syndrome and associated extrahepatic autoimmune diseases.
abstract: OBJECTIVE
  To assess the prevalence of concurrent extrahepatic autoimmune diseases in patients with autoimmune hepatitis (AIH)/primary biliary cirrhosis (PBC) overlap syndrome and applicability of the 'mosaic of autoimmunity' in these patients.
  
  
  METHODS
  The medical data of 71 AIH/PBC overlap patients were evaluated for associated autoimmune diseases.
  
  
  RESULTS
  In the study population, 31 (43.6%) patients had extrahepatic autoimmune diseases, including autoimmune thyroid diseases (13 patients, 18.3%), Sjögren syndrome (six patients, 8.4%), celiac disease (three patients, 4.2%), psoriasis (three patients, 4.2%), rheumatoid arthritis (three patients, 4.2%), vitiligo (two patients, 2.8%), and systemic lupus erythematosus (two patients, 2.8%). Autoimmune hemolytic anemia, antiphospholipid syndrome, multiple sclerosis, membranous glomerulonephritis, sarcoidosis, systemic sclerosis, and temporal arteritis were identified in one patient each (1.4%). A total of 181 autoimmune disease diagnoses were found in our patients. Among them, 40 patients (56.4%) had two, 23 (32.3%) had three, and eight (11.3%) had four diagnosed autoimmune diseases.
  
  
  CONCLUSIONS
  A large number of autoimmune diseases were associated with AIH/PBC overlap patients. Therefore, extended screening for existing autoimmune diseases during the routine assessment of these patients is recommended. Our study suggests that the concept of 'mosaic of autoimmunity' is a valid clinical entity that is applicable to patients with AIH/PBC overlap syndrome.
authors.affiliation: Department of Gastroenterology, Numune Research and Education Hospital, Ankara, Turkey. drcumi21@hotmail.com
authors.forename: Cumali
authors.initials: C
authors.lastname: Efe
authors.forename: Staffan
authors.initials: S
authors.lastname: Wahlin
authors.forename: Ersan
authors.initials: E
authors.lastname: Ozaslan
authors.forename: Alexandra Heurgue
authors.initials: AH
authors.lastname: Berlot
authors.forename: Tugrul
authors.initials: T
authors.lastname: Purnak
authors.forename: Luigi
authors.initials: L
authors.lastname: Muratori
authors.forename: Chiara
authors.initials: C
authors.lastname: Quarneti
authors.forename: Osman
authors.initials: O
authors.lastname: Yüksel
authors.forename: Gérard
authors.initials: G
authors.lastname: Thiéfin
authors.forename: Paolo
authors.initials: P
authors.lastname: Muratori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001323:Autoantibodies / Q000097:blood; D001327:Autoimmune Diseases / Q000453:epidemiology / Q000276:immunology; D005060:Europe / Q000453:epidemiology; D005260:Female; D019693:Hepatitis, Autoimmune / Q000453:epidemiology* / Q000276:immunology; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D012859:Sjogren's Syndrome / Q000453:epidemiology / Q000276:immunology; D013577:Syndrome; D013967:Thyroiditis, Autoimmune / Q000453:epidemiology / Q000276:immunology; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult
chemical_list: D001323:Autoantibodies