MIXED TYPES OF CHRONIC ACTIVE HEPATITIS AND PRIMARY BILIARY-CIRRHOSISASSOCIATED WITH THE ANTIPHOSPHOLIPID ANTIBODY SYNDROME - A CASE-REPORT

An understanding of the pathogenesis of mixed types of chronic active hepatitis and primary biliary cirrhosis is important for the treatment of the patients. A 40-year-old Japanese woman with anti-phospholipid syndrome has been treated with prednisolone for two years since she wa s diagnosed as having a mixed type of chronic active hepatitis and pri mary biliary cirrhosis. Biochemical tests for liver function were norm al during treatment. Laparoscopy revealed a white liver, and histology demonstrated disappearance of the findings of piecemeal necrosis or c hronic nonsuppurative destructive cholangitis in the specimen. Steroid treatment of patients with mixed types of chronic active hepatitis an d primary biliary cirrhosis is controversial, since it is contra-indic ated in some. Although the clinical features of the patients varies fr om one to another, this case suggests that the autoimmune mechanism of some patients may resemble autoimmune hepatitis rather than primary b iliary cirrhosis, and treatment with steroid is effective.