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Arthritis, Eosinophilia, and Autoimmune Liver Disease: A Diagnostic Challenge

Farani, Júlia Boechat*; Albuquerque, Carolina Berzoini*; de Oliveira, Juliano Machado MD, MSc; de Assis, Emílio Augusto Campos Pereira MD; de Oliveira Ayres Pinto, Eduardo MD*; de Lacerda Bonfante, Herval MD, PhD

JCR: Journal of Clinical Rheumatology: March 2015 - Volume 21 - Issue 2 - p 95–98
doi: 10.1097/RHU.0000000000000218
Medical Student Report

Autoimmune hepatitis (AIH) is a chronic liver disease of unknown etiology. It is composed of immune-mediated liver injury and significant immunological aspects. Arthritis can be observed in patients with AIH before recognition of the disease, which can lead to a diagnostic challenge. Although there are few reported cases in literature, peripheral blood eosinophilia might also play a part in such diagnosis. We report an intriguing case of a 41-year-old man who presented to our service with arthritis and eosinophilia as initial manifestations and was eventually diagnosed with overlap syndrome: AIH and primary sclerosing cholangitis. The present report aims to include eosinophilia among the clinical features of AIH, highlighting the possibility of its detection before the onset of either articular or hepatic disturbances.

From the *Division of Rheumatology, Hospital Santa Casa de Misericórdia de Juiz de Fora (SCMJF); †Department of Internal Medicine, School of Medical Sciences and Health of Juiz de Fora (SUPREMA) and Federal University of Juiz de Fora; ‡Department of Pathology, School of Medical Sciences and Health of Juiz de Fora (SUPREMA); §Department of Pharmacology, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

J.B.F. and C.B.A. are undergraduate students in the School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.

The authors declared no potential conflicts of interest. This work did not receive any financial, organizational, pharmaceutical or industry support.

Correspondence: Herval de Lacerda Bonfante, MD, PhD, Department of Pharmacology, Federal University of Juiz de Fora (UFJF), José Lourenço Kelmer, s/n, Campus Universitário, São Pedro, Juiz de Fora, Minas Gerais, Brazil. E-mail: herval.bonfante@ufjf.edu.br.

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