Clinical overlap frequently asymptomatic in early stages, creating challenges
Written by Andrea Lobo, PhD | April 14, 2026

Some people with systemic sclerosis (SSc) have autoimmune hepatitis (AIH), a condition marked by liver inflammation caused by self-reactive antibodies, a study in Turkey shows.

The study also identified the blood levels of the liver enzyme alanine aminotransferase (ALT) as the most accurate predictor of AIH.

“Our findings highlight the critical role of routine biochemical monitoring, with ALT emerging as a highly effective [noninvasive] screening tool to guide clinical decision-making,” researchers wrote.

The study, “Prevalence, clinical features, and laboratory predictors of autoimmune hepatitis in systemic sclerosis: A retrospective single-center cohort study,” was published in Clinical Rheumatology.

Number of reported cases of AIH in people with SSc is low
SSc is an autoimmune disease characterized by the buildup of a protein called collagen, the main component of scar tissue. Liver involvement, particularly AIH, may also be seen in people with SSc.

However, the low number of reported cases of AIH in people with SSc and the fact that this clinical overlap is frequently asymptomatic in early stages represent significant challenges for diagnosis and timely treatment.

To learn more, researchers analyzed the medical records of 111 individuals with SSc followed at a specialized center in Turkey between 2015 and 2025. Participants had a mean age of 52.4 years, a median SSc duration of seven years, and were mostly women (88.3%). Regarding disease types, two-thirds of participants had limited cutaneous SSc, while one-third had diffuse SSc.

Most participants had self-reactive antinuclear antibodies, which target proteins in the cell nucleus (97.1%); interstitial lung disease, diseases that cause inflammation and scarring in the lungs (61.3%); and Raynaud’s phenomenon, when fingers and toes are numb and frigid in response to cold temperatures or stress (95.5%).

Overall, eight participants (7.2%) had AIH, diagnosed at a mean age of 46.5 years. There were no significant differences for age, sex, disease duration, interstitial lung disease, or type of self-reactive antibodies between patients with and without AIH.

Among people with AIH, laboratory tests revealed elevated blood levels of liver enzymes, a potential sign of liver damage, and immunoglobulins (antibodies). Liver biopsy indicated inflammation in all patients with AIH, infiltration of immune cells (75% of patients), and structural reorganization of liver cells (37.5%). One patient had permanent liver scarring, or cirrhosis.
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Further analysis indicated that AIH was not significantly associated with patients’ age, sex, or clinical characteristics.

Report supports ASCT as 'important therapeutic option' for SSc
Written by Marisa Wexler, MS | April 7, 2026

​Autologous stem cell transplant (ASCT), a procedure that essentially aims to reset the immune system, was effective for controlling scleroderma in a teenager with severe disease that wasn’t responding well to medications.

“ASCT may represent an important therapeutic option, particularly perhaps in patients who develop severe disease at a young age,” the researchers wrote.
The report, “Autologous stem cell transplant for severe, progressive juvenile systemic sclerosis,” was published in Stem Cells Translational Medicine.

Scleroderma, also called systemic sclerosis (SSc), is an inflammatory disorder characterized by abnormal scarring that can affect the skin as well as organs throughout the body. Inflammatory disorders such as SSc are marked by dysregulation of the immune system, which normally helps protect the body from infections.
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ASCT basically intends to replace a patient’s stem cells. After intensive treatments such as chemotherapy and radiation wipe out overly reactive immune cells, the collected stem cells are then transplanted back into the patient to grow a new immune system. The aim is essentially to reset the immune system’s activity so it won’t drive inflammatory disease.