Publication Name	World Journal of Clinical Cases
Manuscript ID	55085
Country	Brazil

Category	Medicine, Research & Experimental
Manuscript Type	Systematic Reviews
Article Title	Primary sclerosing cholangitis and autoimmune hepatitis overlap syndrome associated with inflammatory bowel disease: A case report and systematic review
Manuscript Source	Invited Manuscript
All Author List	Vinícius Remus Ballotin, Lucas Goldmann Bigarella, Floriano Riva, Georgia Onzi, Raul Angelo Balbinot, Silvana Sartori Balbinot and Jonathan Soldera
Funding Agency and Grant Number
Corresponding Author	Jonathan Soldera, MD, MSc, Associate Professor, Staff Physician, Clinical Gastroenterology, Universidade de Caxias do Sul, Rua Francisco Getúlio Vargas 1130, Caxias do Sul 95084180, Brazil. jonathansoldera@gmail.com
Key Words	Autoimmune hepatitis; Primary sclerosing cholangitis; Crohn’s disease; Ulcerative colitis; Inflammatory bowel diseases;
Core Tip	We have aimed to report a case of a female patient with autoimmune hepatitis (AIH) and primary sclerosing cholangitis (PSC) overlap syndrome associated to ulcerative colitis and to systematically review the available cases of AIH and PSC overlap syndrome. A previously healthy 22-year-old woman presented with abdominal pain and jaundice. She had a reagent antinuclear factor (1:640, with a homogeneous nuclear pattern). Magnetic resonance cholangiography showed a cirrhotic liver with multiple focal areas of strictures of the intrahepatic bile ducts, with associate dilations. Liver biopsy described periportal necroinflammatory activity, plasmocyte infiltration, and advanced fibrosis. Colonoscopy had shown ulcerative pancolitis and mild activity (Mayo score 1), with a spared rectum. Treatment with corticosteroids, azathioprine, ursodeoxycholic acid and mesalamine was begun, with improvement in laboratory tests. Searches for the systematic review were run on seven electronic databases, retrieving 3349 references. In the final analysis, 44 references were included, with a total of 109 cases reported. The most common clinical finding was jaundice and 43.5% of cases were associated with inflammatory bowel disease. Among these, 27.6% were cases of Crohn’s disease, 68% of ulcerative colitis, and 6.4% of indeterminate colitis. Most patients were treated with steroids. All-cause mortality was 3.7%. In conclusion, PSC and AIH overlap syndrome is generally associated with inflammatory bowel disease and is associated with low mortality and good response to treatment.
Citation	Ballotin VR, Bigarella LG, Riva F, Onzi G,Balbinot RA, Balbinot SS, Soldera J. Primary sclerosing cholangitis and autoimmune hepatitis overlap syndrome associated with inflammatory bowel disease: A case report and systematic review. World J Clin Cases 2020; 8(18): 4075-4093

Received	2020-03-21 14:32
Peer-Review Started	2020-03-21 14:37
To Make the First Decision
Return for Revision	2020-04-08 16:44
Revised	2020-04-23 23:37
Second Decision	2020-07-28 10:25
Accepted by Journal Editor-in-Chief
Accepted by Company Editor-in-Chief	2020-07-30 05:05
Articles in Press	2020-07-30 05:05
Publication Fee Transferred
Edit the Manuscript by Language Editor	2020-08-24 03:16
Typeset the Manuscript	2020-09-15 17:04

ISSN	2307-8960 (online)
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