{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,11]],"date-time":"2026-02-11T19:39:09Z","timestamp":1770838749417,"version":"3.50.1"},"reference-count":30,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2011,8,24]],"date-time":"2011-08-24T00:00:00Z","timestamp":1314144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2011,9]]},"abstract":"<jats:p><jats:bold>Aims:\u2002<\/jats:bold> Primary biliary cirrhosis (PBC) and autoimmune hepatitis (AIH) may simultaneously coexist in some patients, designated as PBC\u2010AIH overlap syndrome. Previous studies suggest that combination therapy of ursodeoxycholic acid (UDCA) and corticosteroids may be effective. In the current study, we aimed to describe clinical features of these cases and to propose a rationale for combination treatment in PBC\u2010AIH overlap.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> We enrolled patients with PBC\u2010AIH overlap from eight referral centers for liver diseases in Japan, and clinical, biochemical and immunological features were examined. Liver histology of all patients at diagnosis were analyzed altogether in detail. Eighty\u2010nine and 44 patients with PBC and AIH alone were included and served as controls.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold> We identified 33 patients with PBC\u2010AIH overlap. The mean follow\u2010up period was 6.1\u2003years. On liver histology, the HA (hepatitis activity) score was significantly higher than the CA (cholangitis activity) score (<jats:italic>P<\/jats:italic>\u2003&lt;\u20030.001). At the end of the follow\u2010up period, corticosteroids were used in 23 patients (72%), and neither liver\u2010related death nor liver transplantation had been noted. The sensitivity and specificity of the simplified AIH scoring system for prediction of patients who required corticosteroids during clinical course was 92% and 75% in the training set (<jats:italic>n<\/jats:italic>\u2003=\u200317), and 91% and 80% in the validation set (<jats:italic>n<\/jats:italic>\u2003=\u200316) of overlap. Only 3% of PBC patients were diagnosed as having indication for corticosteroid use.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold> In PBC\u2010AIH overlap, AIH\u2010like features are dominant in liver histology. The simplified AIH scoring system could predict patients who needed corticosteroids with a higher specificity.<\/jats:p>","DOI":"10.1111\/j.1872-034x.2011.00844.x","type":"journal-article","created":{"date-parts":[[2011,8,31]],"date-time":"2011-08-31T15:11:58Z","timestamp":1314803518000},"page":"877-886","source":"Crossref","is-referenced-by-count":40,"title":["Primary biliary cirrhosis \u2013 Autoimmune hepatitis overlap syndrome: A rationale for corticosteroids use based on a nation\u2010wide retrospective study in Japan"],"prefix":"10.1111","volume":"41","author":[{"given":"Atsushi","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenichi","family":"Harada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirotoshi","family":"Ebinuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Atsumasa","family":"Komori","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junko","family":"Yokokawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaname","family":"Yoshizawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Abe","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuhiro","family":"Miyake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kentaro","family":"Kikuchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromasa","family":"Ohira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikio","family":"Zeniya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kazuhide","family":"Yamamoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiromi","family":"Ishibashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morikazu","family":"Onji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasuni","family":"Nakanuma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hirohito","family":"Tsubouchi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hajime","family":"Takikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,8,24]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra043898"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22906"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.34944"},{"key":"e_1_2_7_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra050408"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2004.11.009"},{"key":"e_1_2_7_7_2","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1016\/S0016-5085(76)80453-2","article-title":"Responses to treatment can differentiate chronic active liver disease with cholangitic features from the primary biliary cirrhosis syndrome","volume":"71","author":"Geubel AP","year":"1976","journal-title":"Gastroenterology"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF00432159"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2005-916322"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1038\/modpathol.3800684"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(99)80297-9"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.1840180435"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2007.01136.x"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05703.x"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.07.013"},{"key":"e_1_2_7_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22322"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.616"},{"key":"e_1_2_7_18_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280203"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.10.017"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1053\/jhep.2002.30902"},{"key":"e_1_2_7_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.03.004"},{"key":"e_1_2_7_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/ajg.2009.126"},{"key":"e_1_2_7_23_2","first-page":"441","article-title":"Therapy response and outcome of overlap syndromes: autoimmune hepatitis and primary biliary cirrhosis compared to autoimmune hepatitis and autoimmune cholangitis","volume":"57","author":"Ozaslan E","year":"2010","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_7_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1746.2009.06018.x"},{"key":"e_1_2_7_25_2","first-page":"701","volume-title":"Diseases of the Liver","author":"Heathcote E","year":"2003"},{"key":"e_1_2_7_26_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1827.2009.02500.x"},{"key":"e_1_2_7_27_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510280203"},{"key":"e_1_2_7_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2010.03.004"},{"key":"e_1_2_7_29_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2002.05703.x"},{"key":"e_1_2_7_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.09.002"},{"key":"e_1_2_7_31_2","doi-asserted-by":"publisher","DOI":"10.1097\/MEG.0b013e328308bbaf"}],"container-title":["Hepatology Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1872-034X.2011.00844.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1872-034X.2011.00844.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T21:31:45Z","timestamp":1697319105000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1872-034X.2011.00844.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,8,24]]},"references-count":30,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2011,9]]}},"alternative-id":["10.1111\/j.1872-034X.2011.00844.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1872-034x.2011.00844.x","archive":["Portico"],"relation":{},"ISSN":["1386-6346","1872-034X"],"issn-type":[{"value":"1386-6346","type":"print"},{"value":"1872-034X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,8,24]]}}}