Primary biliary cholangitis-autoimmune hepatitis overlap syndrome comorbid with pulmonary cryptococcosis： A case report

Patients with overlap syndrome （OS） of autoimmune liver disease may present with more than one biochemical， immunological， histological or cholangiography features of autoimmune liver disease （AILD） and often require a combination of immunosuppressants for treatment. Pulmonary cryptococcosis is a type of invasive pneumomycosis caused by Cryptococcus neoformans or Cryptococcus gattii and has a relatively high incidence rate in immunocompromised patients. This case report presents a patient with OS who was found to have pulmonary cryptococcosis during immunosuppressive therapy and developed abnormal liver function during antifungal treatment. Based on the liver function of the patient， the feasibility of adjusting antifungal agents was assessed， and active treatment strategies for novel cryptococcal infection were developed under the close monitoring of liver function， which helped to avoid the progression of infection. It is suggested that before the initiation of immunosuppressive therapy， systemic foci of infection should be comprehensively evaluated， and suspicious foci of infection should be monitored continuously.