title: Arthritis, eosinophilia, and autoimmune liver disease: a diagnostic challenge.
abstract: Autoimmune hepatitis (AIH) is a chronic liver disease of unknown etiology. It is composed of immune-mediated liver injury and significant immunological aspects. Arthritis can be observed in patients with AIH before recognition of the disease, which can lead to a diagnostic challenge. Although there are few reported cases in literature, peripheral blood eosinophilia might also play a part in such diagnosis. We report an intriguing case of a 41-year-old man who presented to our service with arthritis and eosinophilia as initial manifestations and was eventually diagnosed with overlap syndrome: AIH and primary sclerosing cholangitis. The present report aims to include eosinophilia among the clinical features of AIH, highlighting the possibility of its detection before the onset of either articular or hepatic disturbances.
authors.affiliation: From the *Division of Rheumatology, Hospital Santa Casa de Misericórdia de Juiz de Fora (SCMJF); †Department of Internal Medicine, School of Medical Sciences and Health of Juiz de Fora (SUPREMA) and Federal University of Juiz de Fora; ‡Department of Pathology, School of Medical Sciences and Health of Juiz de Fora (SUPREMA); §Department of Pharmacology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
authors.forename: Júlia Boechat
authors.initials: JB
authors.lastname: Farani
authors.forename: Carolina Berzoini
authors.initials: CB
authors.lastname: Albuquerque
authors.forename: Juliano Machado
authors.initials: JM
authors.lastname: de Oliveira
authors.forename: Emílio Augusto Campos Pereira
authors.initials: EA
authors.lastname: de Assis
authors.forename: Eduardo
authors.initials: E
authors.lastname: de Oliveira Ayres Pinto
authors.forename: Herval
authors.initials: H
authors.lastname: de Lacerda Bonfante
mesh_terms: D000328:Adult; D001168:Arthritis / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D015209:Cholangitis, Sclerosing / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D002908:Chronic Disease; D004802:Eosinophilia / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D019693:Hepatitis, Autoimmune / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D008297:Male