Coexisting Primary Sclerosing Cholangitis and Autoimmune Hepatitis: Overlapping Challenges in Diagnosis and Treatment.

Autor: Fiske HW; Department of Internal Medicine, Warren Alpert Medical School, Brown University, Providence, RI, USA., Saeed F; Division of Gastroenterology, NYU Grossman School of Medicine, New York, NY, USA., Ward C; Division of Gastroenterology, Lahey Hospital and Medical Center, Burlington, MA, USA., Sinayuk B; Department of Radiology, Warren Alpert Medical School, Brown University, Providence, RI, USA., Ulici V; Department of Pathology, Mayo Clinic, Rochester, MN, USA., Curry M; Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, MA, USA., Feller E; Division of Medical Education, Warren Alpert Medical School, Brown University, Providence, RI, USA., Shah SA; Division of Gastroenterology, Warren Alpert Medical School, Gastroenterology Associates Inc, Brown University, Providence, RI, USA.
Jazyk: angličtina
Zdroj: Case reports in gastroenterology [Case Rep Gastroenterol] 2024 Mar 26; Vol. 18 (1), pp. 167-175. Date of Electronic Publication: 2024 Mar 26 (Print Publication: 2024).
DOI: 10.1159/000537798
Abstrakt: Introduction: Hepatobiliary overlap syndromes describe the coinciding presentation of more than one immune-mediated biliary and liver disease in a single patient and present complex challenges in diagnosis and treatment. We report a case of ulcerative colitis with primary sclerosing cholangitis and autoimmune hepatitis overlap syndrome responsive to vancomycin.
Case Presentation: The patient is a 30-year-old female with known ulcerative pancolitis and autoimmune hepatitis. She presented to the emergency department with a constellation of gastrointestinal symptoms, including diffuse lower abdominal pain, bloody diarrhea, and nausea with bilious vomiting. Subsequent imaging revealed the additional diagnosis of primary sclerosing cholangitis, and she was diagnosed with overlap syndrome. Multiple treatment regimens were trialed with minimal improvement. She eventually achieved normalization of both clinical status and biochemical markers after the addition of vancomycin.
Conclusion: Vancomycin is an underutilized therapy; its potential role in primary sclerosing cholangitis and autoimmune hepatitis overlap syndrome has not been previously reported.
Competing Interests: The authors of this manuscript have no conflicts of interest to declare with respect to the research, authorship, and/or publication of this article.
(© 2024 The Author(s). Published by S. Karger AG, Basel.)
Databáze: MEDLINE
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