In patients with PBC and possible autoimmune hepatitis overlap on immunosuppression, how do you decide whether improvement in ALT/IgG after starting a PPAR agonist reflects adequate control of hepatitic activity versus nonspecific biochemical improvement, and how (if at all) does that influence immunosuppression adjustments?
1 Answer
Mednet MemberInvited Expert
Hepatology · Northwestern Memorial Hospital
Answered on
It is important to establish how convincing the diagnosis of overlap is. I use several different sources of information:
- Histology: interface hepatitis with a rich lymphoplasmacytic infiltrate (predominant) plus bile duct injury, or bile duct injury predominant with little to no hepatitis.
- Serum ma...
Join for free or sign in to see the full answer