Overlap Syndrome of Autoimmune Hepatitis, Primary Biliary Cholangitis and Primary Sclerosing Cholangitis in a patient with Systemic Lupus Erythematosus: A Case Report of Complex Autoimmune Liver Disease

Overlap syndrome is a spectrum of clinical manifestations of autoimmune hepatitis (AIH), Primary Biliary Cholangitis (PBC), and Primary Sclerosing Cholangitis (PSC). It is extremely rare for PBC, PSC, and AIH to occur in the same patient. We present a 48-year-old Hispanic man with a history of SLE who presented with elevated liver enzyme. He was found to have liver cirrhosis and diagnosed with PBC, PSC, and probable AIH overlap syndrome. To our knowledge, this is only the second reported case of all these diseases overlapping in the same patient; and the first reported case in a patient with SLE.