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Concurrent Autoimmune Diseases in Patients With Autoimmune Hepatitis

Teufel, Andreas MD, PhD*; Weinmann, Arndt MD*; Kahaly, George J. MD*; Centner, Catherine MD*; Piendl, Anja MD*; Wörns, Marcus MD*; Lohse, Ansgar W. MD; Galle, Peter R. MD*; Kanzler, Stephan MD* ‡

Journal of Clinical Gastroenterology: March 2010 - Volume 44 - Issue 3 - p 208-213
doi: 10.1097/MCG.0b013e3181c74e0d

Background Although the pathomechanisms of autoimmune diseases in various organs remain unresolved, an accumulation of autoimmune diseases in individual patients has been observed. An overlap of autoimmune hepatitis (AIH) and primary biliary cirrhosis (PBC) or primary sclerosing cirrhosis has been well documented. However, the overlap of autoimmune diseases other than PBC or PSC has not yet been investigated in a large cohort.

Goal The goal of our analysis was to investigate the incidence of concurrent autoimmune diseases in patients with AIH.

Study We analyzed our cohort of 278 patients with AIH for concurrent autoimmune diseases.

Results A total of 111 patients (40%) were diagnosed with additional autoimmune diseases. Besides overlap syndromes for PBC and PSC, autoimmune thyroiditis was the most common concurrent disease (28 patients, 10%). Other concurrent autoimmune diseases comprised vitiligo (5 patients), rheumatoid arthritis (5 patients), Sjogren syndrome (4 patients), ulcerative colitis (4 patients), conjunctivitis (4 patients), celiac disease (3 patients), systemic lupus erythematodes (2 patients), type I diabetes (2 patients), multiple sclerosis (2 patients), polymyalgia rheumatica (2 patients), and urticaria (2 patients). One patient each was diagnosed with Crohn's disease, autoimmune gastritis, collagenous colitis, hypophysitis, and sarcoidosis. Investigating 100 patients with polyglandular syndrome and autoimmune thyroid disease for the occurrence of autoantibodies associated with AIH, we identified AIH-associated antibodies only in 1 patient.

Conclusions Concurrent autoimmune diseases are common in patients with AIH and mirror the full range of known autoimmune diseases. Therefore, an extended diagnostic screening for accumulating autoimmune diseases, especially autoimmune thyroiditis, seems reasonable in patients with AIH.

*Department of Medicine I, Johannes Gutenberg University, Mainz

Department of Medicine I, University of Hamburg, Hamburg

Department of Medicine II, Leopoldina Hospital, Schweinfurt, Germany

This study has not been supported by any grants.

Reprints: Stephan Kanzler, MD, Department of Medicine II, Leopoldina Hospital, Gustav-Adolf-Str. 8, 97422 Schweinfurt, Germany (e-mail:

Received for publication February 8, 2009; accepted October 21, 2009

None of the authors has any conflicts of interest.

© 2010 Lippincott Williams & Wilkins, Inc.