scholarly journals Secondary Sclerosing Cholangitis and Hodgkin's Lymphoma

2015 ◽  
Vol 8 ◽  
pp. CCRep.S23665 ◽  
Author(s):  
Seyed Hassan Abedi ◽  
Maryam Ghassami ◽  
Mahsa Molaei ◽  
Zhaleh Mohsenifar ◽  
Amir Houshang Mohammad Alizadeh
Keyword(s):  
Sclerosing Cholangitis ◽  
Viral Infections ◽  
Histological Finding ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Drug Induced ◽  
Laboratory Findings ◽  
Secondary Sclerosing Cholangitis ◽  
Extrahepatic Bile Ducts ◽  
Vanishing Bile Duct

Context Liver damage is relatively common in patients affected by HL, but paraneoplastic cholestasis is an uncommon presenting symptom in HL. Case Report We report the case of a 38-year-old man who came to our hospital with jaundice, pruritis, nausea, vomiting, weight loss, and recurrent episodes of fever without any hepatosplenomegaly or lymphadenopathy. Laboratory findings showed abnormal liver functioning with mixed hepatocellular and cholestatic patterns. Sonographic evaluation of the biliary tract was normal. We ruled out viral infections, autoimmune process, and hemochromatosis. The patient was put on ursobile and NAC ( N-acetyl-systeine) and prednisolone treatment. In magnetic resonance cholangiopancreatography examination, there were multiple strictures in the intrahepatic and extrahepatic bile ducts with mild dilatation. Histologic finding of liver biopsy was compatible with sclerosing cholangitis or drug-induced cholestasis. General condition and laboratory examination results of the patient became better, but we found lymphadenopathy on monthly follow-up examination. Histological finding of the lymph node was compatible with HL. Conclusion This report emphasizes that HL can be presented with different paraneoplastic symptoms and that one of them is secondary sclerosing cholangitis. It has better prognosis than vanishing bile duct syndrome, and perhaps steroid treatment can be suggested.

Secondary sclerosing cholangitis in patients with drug-induced liver injury

2015 ◽  
Vol 47 (6) ◽  
pp. 502-507 ◽  
Author(s):  
Hafsteinn O. Gudnason ◽  
Helgi K. Björnsson ◽  
Marianna Gardarsdottir ◽  
Hjalti M. Thorisson ◽  
Sigurdur Olafsson ◽  
...  
Keyword(s):  
Liver Injury ◽  
Sclerosing Cholangitis ◽  
Drug Induced ◽  
Secondary Sclerosing Cholangitis ◽  
Drug Induced Liver Injury

scholarly journals Secondary sclerosing cholangitis in critically ill patients: a rare disease precipitated by severe SARS-CoV-2 infection

2020 ◽  
Vol 13 (11) ◽  
pp. e237984
Author(s):  
Kate Edwards ◽  
Miles Allison ◽  
Sekina Ghuman
Keyword(s):  
Rare Disease ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Sclerosing Cholangitis ◽  
Multiorgan Failure ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Secondary Sclerosing Cholangitis ◽  
Organ Failures ◽  
Cholestatic Liver Injury ◽  
Underlying Pathophysiology

A previously well 59-year-old man required a prolonged intensive care unit stay due to severe COVID-19 symptoms. During the admission, he developed a cytokine storm, also known as secondary haemophagocytic lymphohistocytosis, and multiorgan failure. Despite recovering from his other organ failures, his liver function continued to deteriorate. Magnetic resonance cholangiopancreatography and subsequent endoscopic retrograde cholangiopancreatography revealed extensive intrahepatic duct dilatation with ‘beading’ but common bile duct sparing. Given the patient had no primary liver disease prior to admission, we considered secondary causes of cholestatic liver injury; this led us to an unusual diagnosis of secondary sclerosing cholangitis in critically ill patients. This case demonstrates a rare disease that has developed specifically in the context of SARS-CoV-2 infection. A review of current literature and the underlying pathophysiology for this rare disease are discussed, particularly in relation to COVID-19.

scholarly journals Sclerosing Cholangitis in Behçet’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Aida Ben Slama Trabelsi ◽  
Dhilel Issaoui ◽  
Mehdi Ksiaa ◽  
Ahlem Souguir ◽  
Nadia Mama ◽  
...  
Keyword(s):  
Bile Duct ◽  
Sclerosing Cholangitis ◽  
Bile Ducts ◽  
Previous History ◽  
Cholestatic Jaundice ◽  
Causal Mechanism ◽  
Behçet Disease ◽  
Behcet Disease ◽  
Secondary Sclerosing Cholangitis ◽  
Extrahepatic Bile Ducts

Introduction. Sclerosing cholangitis is characterized by an inflammatory and fibrotic lesion of intra- and/or extrahepatic bile ducts. When a causal mechanism of a bile duct lesion is identified, the sclerosing cholangitis is considered secondary. The vasculitis, including the Behçet disease, is cited as a probable cause of the ischemia and the sclerosing cholangitis. No cases of extrahepatic secondary sclerosing cholangitis have been reported to date.Case Report. We report the first case of secondary sclerosing cholangitis of the extrahepatic bile ducts associated with Behçet disease in a male who is aged 43, with a previous history of the angio-Behçet followed by complications of thrombophlebitis and a cerebral thrombophlebitis, and who has a cholestatic jaundice. The diagnosis has been carried out by the MR cholangiopancreatography which has objectified a moderate distension of the intrahepatic bile ducts upstream of regular stacked parietal thickening of the main bile duct. The patient has been treated successfully with the ursodeoxycholic acid and the placement of a plastic stent.Conclusion. This diagnosis should be mentioned to any patient with vasculitis and who has a cholestatic jaundice.

scholarly journals Secondary sclerosing cholangitis uncovered during endoscopic retrograde cholangiopancreatography (ERCP) in a patient with chronic choledocholithiasis

2014 ◽  
Vol 1 (1) ◽  
pp. 30 ◽  
Author(s):  
Stefania Chetcuti Zammit ◽  
Jurgen Gerada ◽  
Jason Attard ◽  
James Pocock
Keyword(s):  
Liver Cirrhosis ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Sclerosing Cholangitis ◽  
Common Bile Duct Stones ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Biliary Cirrhosis ◽  
Endoscopic Retrograde ◽  
Secondary Sclerosing Cholangitis ◽  
Biliary Dilatation ◽  
Secondary Biliary Cirrhosis

Untreated biliary cholestasis such as in the case of choledocholithiasis with biliary obstruction can lead to inflammatory strictures, recurrent cholangitis, the formation of more stones and eventually secondary biliary cirrhosis. This can lead to a shortened life expectancy. We report a case of a 61 year old male from Somalia, who presented with recurrent painless jaundice. He had had similar presentations in another country but lacked documentation to show the treatment ensued. Liver function tests (LFTs) at our institution showed evidence of cholestasis. Repeated initial radiological studies failed to show any biliary dilatation and/or obstruction but did reveal evidence of liver cirrhosis with portal hypertension. A liver biopsy at this stage showed bile plugs consistent with a cholestatic picture, as well as evidence of secondary biliary cirrhosis. A magnetic resonance cholangiopancreatography (MRCP) confirmed the presence of biliary dilatation secondary to choledocholithiasis. He underwent an endoscopic retrograde cholangiopancreatography (ERCP), which showed common bile duct stones and an associated biliary stricture, as well as features suggestive of secondary sclerosing cholangitis (SSC) of the intrahepatic ducts. Dilatation and stenting of the stricture were performed, while complete stone clearance was achieved at the second ERCP. LFTs decreased gradually thereafter. Biliary drainage in a patient with cholestasis from a mechanical cause should be the mainstay of treatment. Every effort should be made to prevent the development of chronic cholestasis due to the risk of developing SSC and biliary cirrhosis. Our patient had unfortunately developed chronic choledocholithiasis, with radiological and histological evidence of liver cirrhosis at the time of presentation at our institution.

scholarly journals The Difficult Path to Correct Diagnosis of Hepatolithiasis: A Case Report

2021 ◽  
Vol 64 (2) ◽  
pp. 125-128
Author(s):  
Peter Mikolajčík ◽  
Alexander Ferko ◽  
Michal Demeter ◽  
Martin Vorčák ◽  
Ľudovít Laca
Keyword(s):  
Clinical Picture ◽  
Correct Diagnosis ◽  
Magnetic Resonance Cholangiopancreatography ◽  
Good Prognosis ◽  
Definitive Treatment ◽  
Stone Extraction ◽  
Laboratory Findings ◽  
Biliary Ducts ◽  
Obstructive Cholangitis

Hepatolithiasis is a benign disease, where stones are localized proximal to the confluence of hepatic ducts. The clinical picture may differ depending on whether the stones cause complete, partial, or intermittent biliary obstruction. The course can vary from asymptomatic to fatal, thus, early diagnosis and treatment is critical for a good prognosis. The gold standard in imaging is magnetic resonance cholangiopancreatography (MRCP). However, correct diagnosis can be challenging due to atypical clinical picture and laboratory findings. We present a case where hepatolithiasis was misdiagnosed initially due to incomplete reporting and documentation of MRCP. Choledocholithiasis was diagnosed based on initial MRCP, and endoscopic stone extraction was indicated. However, an unusual post-interventional course and signs of obstructive cholangitis led to an endoscopic re-intervention, which confirmed absence of pathology in extrahepatic biliary ducts. The cholangitis recurrence required intensive antibiotic treatment, and CT examination revealed intrahepatic S3 bile duct dilatation. Thus, a re-evaluation of initial MRCP and repeated MRCP confirmed hepatolithiasis. Further, laparoscopic bisegmentectomy was chosen as the definitive treatment due to the location of the lesion. The patient recovered and remained symptom free upon a 12 month follow up.

Mo1810 Secondary Sclerosing Cholangitis in Patients With Drug Induced Liver Injury

2014 ◽  
Vol 146 (5) ◽  
pp. S-1001
Author(s):  
Hafsteinn O. Gudnason ◽  
Sigurdur Olafsson ◽  
Ottar M. Bergmann ◽  
Helgi K. Bjornsson ◽  
Marianna Gardarsdottir ◽  
...  
Keyword(s):  
Liver Injury ◽  
Sclerosing Cholangitis ◽  
Drug Induced ◽  
Secondary Sclerosing Cholangitis ◽  
Drug Induced Liver Injury
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