AUTOIMMUNE HEPATITIS IN INFLAMMATORY BOWEL-DISEASE - REPORT OF 2 UNUSUAL CASES

Elevated transaminases occur in up to 17% in patients with inflammator y bowel disease. Primary sclerosing cholangitis (PSC) is an important cause for elevated liver enzymes in these patients whereas autoimmune hepatitis is rare. Both diseases can overlap. We report two patients w ith an autoimmune hepatitis. One patient had Crohn's disease and arthr itis with morphological liver changes typical for autoimmune hepatitis but without the characteristic autoantibody pattern. The other patien t suffered from ulcerative colitis. He had antinuclear and antiactin a ntibodies as in autoimmune hepatitis type I, however, histological exa mination of the liver showed bile duct changes. Transaminases declined significantly in both patients after onset of steroid treatment. Ther efore, the diagnosis of autoimmune hepatitis in patients with inflamma tory bowel disease must not be missed, as immunosuppressive therapy im proves the prognosis of the illness.