Autoimmune Hepatitis, Sclerosing Cholangitis, and Autoimmune Sclerosing Cholangitis or Overlap Syndrome

Autoimmune hepatitis (AIH) is characterized by elevated serum aminotransferases, immunoglobulin G, autoantibodies, and interface hepatitis, in the absence of a known diagnosis. Presentation is varied. Therapy is with immunosuppression. There is inflammation of the intrahepatic and/or extrahepatic bile ducts in sclerosing cholangitis (SC), and when associated with inflammatory bowel disease, it is known as primary SC (PSC), with ursodeoxycholic acid used for therapy. The overlap of clinical, biochemical, and histologic features of AIH and PSC is known as autoimmune sclerosing cholangitis (ASC) or overlap syndrome. Liver transplant is performed when medical treatment fails, and both AIH and PSC may recur posttransplant.