Hepatic Overlap Syndrome: Glass of Autoimmune Mimicry - Half
Empty and Half Filled
Hussain Haroon, Pyar Ali Fazel, Ahsan Mobin, Muhammad Naeem, Shirjeel Hussain,
Karim Ullah Makki.
OBJECTIVE: To unfold the iceberg entity of hepatic overlap syndrome among patient with established
chronic liver diseases.
METHODOLOGY: Forty-one patients were referred from the remote areas of Sindh province during
March 2008 to August 2010 to Department of Internal Medicine at Civil Hospital, Karachi,
Pakistan. These patients were unresponsive to the treatment(s) being prescribed. The complete
biochemical, clinical, serological and histopathological profiles of these patients was assessed.
The Chazouillères criterion was used to diagnose the overlap syndrome cases (according to
which an AIH-PBC overlap syndrome would be accepted when 2 out of 3 criteria each of AIH or
PBC is fulfilled). Data were analyzed through SPSS version 16.0. Frequencies and means were
calculated. Serological markers were correlated against biopsy patterns by Pearsons, Cramers
V test, Mantel-Haenszel Test to measure the odd of getting the particular biopsy pattern and 2-
sided significance level
Key words: Hepatic Overlap Syndrome; Chronic Liver Disease; Chazouillères criterion; Hashimotos