{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T07:49:05Z","timestamp":1792050545934,"version":"4.4.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T00:00:00Z","timestamp":1770163200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Autoimmune hepatitis (AIH) overlap syndromes are conditions wherein features of AIH coexist with those of primary sclerosing cholangitis (PSC) or primary biliary cholangitis (PBC). We aimed to evaluate their clinical presentation, treatment response, and disease outcome in an Arab cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      AIH overlap patients, based on the Paris criteria for PBC\/AIH overlap (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 19), and revised International Autoimmune Hepatitis Group (IAIHG) score for PSC\/AIH overlap (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 17) were reviewed at a single center in Saudi Arabia, from 2001 to 2024. Biopsy-proven standalone AIH patients (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      = 93) were included as controls. The primary endpoint was disease progression, liver transplantation, or mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Overall, the AIH and overlap syndrome cohorts were diagnosed at similar ages. Post-treatment Model for End-stage Liver Disease (MELD) and Child-Turcotte-Pugh (CTP) scores did not improve in the PBC\/AIH cohort (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &gt; 0.05), while in PSC\/AIH, the CTP (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.005) and Mayo Clinic scores improved (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.002). In PBC\/AIH and PSC\/AIH cohorts, disease progression and disease remission rates were comparable. The median relapse-free survival (RFS) was 10.4 years for PBC\/AIH, and 13.8 years for PSC\/AIH cohorts (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.256). The 5- and 10-year RFS rates for the AIH, PBC\/AIH, and PSC\/AIH cohorts were 92.3% and 72.7%, 81.3% and 53.4%, and 81.4% and 67.9%, respectively. Higher initial Mayo (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.035) and CTP score (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.028) predicted development of disease composite endpoint (disease progression, liver transplantation, or death).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Despite lack of standardized treatment protocols, AIH, and overlap syndromes respond comparably well to treatment, in addition to similar disease remission and RFS between PBC\/AIH and PSC\/AIH patients. More extended follow-up studies are warranted for patients with overlap syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/sjg.sjg_413_25","type":"journal-article","created":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T18:01:13Z","timestamp":1770228073000},"page":"241-250","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Autoimmune hepatitis overlap syndrome: Clinical presentation, treatment response, and disease evolution: Tertiary centre experience"],"prefix":"10.4103","volume":"32","author":[{"given":"Abduljaleel","family":"Al Alwan","sequence":"first","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ibrahim","family":"Altraif","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"Department of Medicine, Suliman Fakeeh Hospital, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hamdan","family":"Alghamdi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulrahman","family":"Aljumah","sequence":"additional","affiliation":[{"name":"College of Medicine, Dar Al Uloom University, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Omar","family":"Amer","sequence":"additional","affiliation":[{"name":"National Liver Institute, Menoufia University, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dua O.","family":"Binjabal","sequence":"additional","affiliation":[{"name":"International Medical Center, Jeddah, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali H.","family":"Albenmousa","sequence":"additional","affiliation":[{"name":"Organ Transplant Center, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad S.","family":"Shawaqfeh","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lolwa","family":"Fetyani","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesam S.","family":"Abdel-Razaq","sequence":"additional","affiliation":[{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdulkareem M.","family":"Albekairy","sequence":"additional","affiliation":[{"name":"King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fakhar A.","family":"Arisar","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khalid H.","family":"Alharbi","sequence":"additional","affiliation":[{"name":"College of Medicine, King Saud bin Abdulaziz University for Health Sciences, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdulaziz Medical City, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"},{"name":"King Abdullah International Medical Research Centre, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal M.","family":"Sanai","sequence":"additional","affiliation":[{"name":"Department of Medicine, Gastroenterology Section, King Abdulaziz Medical City, King Abdullah International Medical Research Centre, 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