Evolución de cirrosis biliar primaria a síndrome de solapamiento con hepatitis autoinmune en paciente con hepatitis B crónica / Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome in a patient with chronic hepatitis B infection

Se presenta el caso de una paciente con diagnóstico previo de cirrosis biliar primaria (CBP) y hepatitis B crónica en fase de portador inactivo que, en tratamiento con ácido ursodesoxicólico, presentó elevación de las transaminasas, sin datos de reactivación de su hepatitis B crónica. Se realizó biopsia hepática en la que se observaron cambios compatibles con hepatitis autoinmune (HAI) sobreañadida. Las alteraciones analíticas respondieron al tratamiento con budesonida. Se realiza una revisión sobre la entidad clínica del síndrome de solapamiento CBP-HAI y las características especiales de esta paciente para alcanzar el diagnóstico y su tratamiento (AU)

We describe the case of a female patient with a previous diagnosis of primary biliary cirrhosis (PBC) and chronic hepatitis B in inactive phase who developed increased transaminase levels with no evidence of hepatitis B virus reactivation while receiving ursodeoxycholic acid treatment. A liver biopsy showed changes compatible with overlapping autoimmune hepatitis (AIH). Budesonide treatment achieved normalization of transaminase levels. We provide a review of PBC and AIH overlap syndrome and discuss the particular features of this case that led us to this diagnosis, as well as the treatment provided (AU)

[Primary biliary cirrhosis-autoimmune hepatitis overlap syndrome in a patient with chronic hepatitis B infection]. / Evolución de cirrosis biliar primaria a síndrome de solapamiento con hepatitis autoinmune en paciente con hepatitis B crónica.

We describe the case of a female patient with a previous diagnosis of primary biliary cirrhosis (PBC) and chronic hepatitis B in inactive phase who developed increased transaminase levels with no evidence of hepatitis B virus reactivation while receiving ursodeoxycholic acid treatment. A liver biopsy showed changes compatible with overlapping autoimmune hepatitis (AIH). Budesonide treatment achieved normalization of transaminase levels. We provide a review of PBC and AIH overlap syndrome and discuss the particular features of this case that led us to this diagnosis, as well as the treatment provided.