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Case Reports
. 2023 Aug 13;15(8):e43403.
doi: 10.7759/cureus.43403. eCollection 2023 Aug.

A Rare Case of Primary Sclerosing Cholangitis Overlapped With Autoimmune Hepatitis and Ulcerative Colitis

Saraswathi Lakkasani  1 , Gowthami Sai Kogilathota Jagirdhar  2   3 , Murad Qirem  4 , Scott W Digiacomo  5 , Srinivasa Pantula  6
Affiliations
Case Reports

A Rare Case of Primary Sclerosing Cholangitis Overlapped With Autoimmune Hepatitis and Ulcerative Colitis

Saraswathi Lakkasani et al. Cureus. .

Abstract

Primary sclerosing cholangitis (PSC) is a liver disease of idiopathic origin, displaying a diverse and varied nature, which leads to cholestasis. It is characterized by continuous, advancing inflammation and fibrosis in the bile ducts. PSC is closely linked with inflammatory bowel disease and poses a risk for colon, bile duct, and gallbladder cancer. Unfortunately, there is currently no effective medical treatment available for this condition. In some cases, the disease may progress to end-stage liver failure, making liver transplantation a possible necessity for affected individuals. PSC association with autoimmune hepatitis (AIH) is very rare. This is a case of PSC that is overlapped with AIH. Screening colonoscopy showed colitis, and a biopsy was consistent with ulcerative colitis without any colitis symptoms, emphasizing the need for ruling out any other associated conditions, which respond well to the effective treatment to avoid morbidity and mortality in PSC.

Keywords: autoimmune hepatitis; cholestasis; primary sclerosing cholangitis (psc); ulcerative colıtıs; ursodeoxycholic acid.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Colonoscopy showing erythema and loss of vascularity in descending colon
Figure 2
Figure 2. Colonoscopy showing erythema near splenic flexure
Figure 3
Figure 3. Colonic biopsy showing lymphocytic infiltration in mucosal and submucosa
Figure 4
Figure 4. Descending colon biopsy showing inflammatory cells with crypt abscess
See this image and copyright information in PMC

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