Overlap syndrome of primary sclerosing cholangitis and autoimmune hepatitis.

We report a 46-year-old patient with the typical biochemical, histological and cholangiographic findings of primary sclerosing cholangitis (PSC) whose clinical and laboratory findings would also qualify her for the diagnosis of definite autoimmune hepatitis (AIH), according to the aggregate score of the International Autoimmune Hepatitis Group. We suggest that this patient may represent an example of the overlapping syndrome of PSC and AIH.

Giant cell arteritis presenting as pulseless disease of the upper extremities.

The most frequently recognized clinical features of giant cell arteritis (GCA) derive from the involvement of the cranial arteries. In 10% of patients, however, the aorta and its major branches, are also affected. We report a case of a 53-year-old woman presenting with a fainting episode and diminished pulses in the upper extremities. Histologic examination of the temporal artery revealed features of giant cell arteritis.

Hepatocellular carcinoma presenting with paraneoplastic neurologic syndrome in a hepatitis B surface antigen-positive patient.

We report a hepatitis B surface antigen-positive patient who presented with paraneoplastic peripheral sensorimotor polyneuropathy and cranial nerve involvement, 6 months before a diagnosis of hepatocellular carcinoma was made. This makes us think that neurologic manifestations in hepatitis B surface antigen-positive patients warrant investigation to exclude an underlying hepatocellular carcinoma.