J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website http://www.jocmr.org

Case Report

Volume 4, Number 6, December 2012, pages 429-433

Overlapping of Primary Biliary Cirrhosis and Small Duct Primary Sclerosing Cholangitis: First Case Report

Figures

Figure 1. Indirect immunofluorescence on HEp-2 cells (Bion Interprise Ltd) with human serum diluted 1/80. (A) Pattern nuclear envelope; (B) and cytoplasmic discrete speckled pattern, suggestive of antimitocondrial positivity; (C) Chromosome metaphase plate negative. Magnification x 400.

Figure 2. Portal fibrosis with portal-portal linking septa, and complete obliteration of bile duct which is replaced by dense fibrous whorls (Arrow). H and E, 40 x.

Figure 3. Small bile duct showing an “onion-skin” type of periductal fibrosis. H and E, 40 x.

Table

**Table 1.** Case Report: Laboratory Findings
	29/04/04	28/05/04	05/06/06	31/08/06	31/08/06
HBsAg, hepatitis B surface antigen; Anti-HBc, antibody against core antigen of hepatitis B virus; anti-HCV, antibody against hepatitis C virus; ANA: anti-nuclear antibody; SMA: Smooth muscle antibodies; Anti-LKM: Liver-kidney microsomal antibodies; Anti-SLA/LP: Antibodies against soluble liver antigen/liver pancreas; pANCA: Perinuclear antineutrophil cytoplasmic antibodies. AMA M2: Antibodies to mitochondrial E2-pyruvate dehydrogenase; Anti-Sp100: Antibodies to Sp100; Anti-gp210: Antibodies to gp210.
AST (UI/mL)	98 (45)	79( 45)	42 (45)	116 (45)	26 (45)
ALT (UI/mL)	125 (35)	68 (35)	38 (35)	167 (35)	14 (35)
GGT (UI/mL)	227 (48)	249 (48)	408 (38)	383 (38)	12 (38)
AP (UI/mL)		472 (147)	211 (147)	468 (147)	83 (147)
Total Bilirub (mg/dL)		0.41	0.59
Dir. Bilirub (mg/dL)		0.06	0.17
INR			1.0
Albumin (g/L)		4.5	4.3
Gamma-glob (g/L)			1.6
Total cholesterol (mg/dL)	177
HDL -C (mg/dL)	52
Triglycerides (mg/dL)	116
IgM (mg/dL)		183
IgG (mg/dL)		1460
HBsAg	Neg
Anti-HBc	Neg
anti-HCV	Neg
ANA	Pos
anti-SMA	Neg
anti-LKM-1	Neg
anti-SLA	Neg
p-ANCA	Neg
AMA M2	Pos
Anti-Sp100	Pos
Anti-gp210	Pos