Article Text

Curriculum based clinical reviews
Autoimmune liver disease: evaluating overlapping and cross-over presentations—a case-based discussion
  1. Margaret Corrigan1,2,
  2. Gideon M Hirschfield1,2
  1. 1NIHR Birmingham Liver Biomedical Research Unit, University of Birmingham, Birmingham, UK
  2. 2Queen Elizabeth Hospital, Birmingham, UK
  1. Correspondence to Dr G M Hirschfield, Centre for Liver Research, Institute of Immunology and Immunotherapy, University of Birmingham, Wolfson Drive, B15 2TT, UK; g.hirschfield{at}


The three classic autoimmune liver diseases are recognised based on identifying varying clinical, laboratory, histological and radiological features that collectively classify patients. In the absence of defined aetiological factors, it is recognised that disease spectrum is broad, and, in this context, it is not infrequent for disease boundaries to be blurred, leading to overlapping features that may be present at the time of diagnosis or may appear later in the course of disease. Given the absence of accepted diagnostic criteria for overlap/cross-over syndromes, alongside weak data for intervention, it is recommended that a multidisciplinary, patient-specific approach be used to establish individual treatment pathways.


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