title: Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome: simplified criteria may be effective in the diagnosis in Chinese patients.
abstract: OBJECTIVE
  To evaluate the Paris criteria, the revised diagnostic criteria and the simplified diagnostic scoring system in the diagnosis of primary biliary cirrhosis (PBC)-autoimmune hepatitis (AIH) overlap syndrome in Chinese patients.
  
  
  METHODS
  Medical records of the patients who were diagnosed with PBC at the Union Hospital and Tongji Hospital, Tongji Medical University, Huazhong University of Science and Technology (Wuhan, Hubei Province, China) from 2003 to 2012 were retrospectively reviewed. The overlap syndrome was diagnosed based on the Paris criteria, the revised criteria and the simplified criteria, respectively. Patients' clinical characteristics, laboratory examination results and histological findings were collected. The sensitivity and specificity of the three criteria for diagnosing PBC-AIH overlap syndrome were calculated.
  
  
  RESULTS
  PBC-AIH overlap syndrome was diagnosed in 2, 13 and 10 patients with PBC based on the Paris, the revised and the simplified criteria, respectively. The sensitivity and specificity of the simplified criteria in diagnosing the overlap syndrome was 90.0% and 98.2%, which were the highest among the three criteria, followed by the revised criteria. The Paris criteria showed a high specificity (100%) but a relatively low sensitivity (20.0%). In addition, some patients who did not fulfil the Paris criteria still benefited from the immunosuppressive agents.
  
  
  CONCLUSIONS
  For Chinese patients with the PBC-AIH overlap syndrome, the simplified criteria appear to be the most efficacious compared with the Paris criteria and the revised criteria. Further studies should be performed to confirm these observations with respect to long-term outcomes and therapeutic implications.
authors.affiliation: Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Liu
authors.forename: Zhen Guo
authors.initials: ZG
authors.lastname: Pan
authors.forename: Jin
authors.initials: J
authors.lastname: Ye
authors.forename: Dong
authors.initials: D
authors.lastname: Xu
authors.forename: Hui
authors.initials: H
authors.lastname: Guo
authors.forename: Gang Ping
authors.initials: GP
authors.lastname: Li
authors.forename: Ke Shu
authors.initials: KS
authors.lastname: Xu
authors.forename: Xiao Hua
authors.initials: XH
authors.lastname: Hou
authors.forename: Yu Hu
authors.initials: YH
authors.lastname: Song
mesh_terms: D000328:Adult; D000465:Algorithms; D044466:Asian People; D002681:China; D005260:Female; D019693:Hepatitis, Autoimmune / Q000175:diagnosis*; D006801:Humans; D008105:Liver Cirrhosis, Biliary / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013577:Syndrome
keywords: autoimmune hepatitis; biliary liver cirrhosis; diagnosis; immunosuppresion; overlap syndrome; patient selection