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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Rashid, Mohammed Kalinke, Lukas |
| Description | Author Affiliation: Kalinke L ( Department of Acute Medicine, Princess Royal Hospital, Haywards Heath, UK. lkalinke@gmail.com) |
| Abstract | A 28-year-old man with hereditary spherocytosis presented with abdominal pain and jaundice. He had severe, mainly conjugated (642 µmol/l), hyperbilirubinaemia (1033 µmol/l), with elevated liver enzymes: alkaline phosphatase (ALP) (163 IU/l), γ-glutamyltransferase (gGT) (277 IU/l) and aspartate transaminase (AST) (358 IU/l). Abdominal ultrasound and magnetic resonance cholangiopancreatography (MRCP) showed gallstones in the gallbladder but an absence of biliary duct dilation. Liver biopsy was consistent with cholestasis but showed no large duct obstruction. The cause of the cholestasis was unclear, was it a primary intrahepatic pathology or secondary to a posthepatic cause? He presented with similar symptoms days later with gallstones in the bile duct (choledocholithiasis) and underwent endoscopic retrograde cholangiopancreatography (ERCP) and cholecystectomy. This report guides one through the assessment of jaundice and serves as an example whereby the diagnosis of a common cause of illness is blurred by an atypical clinical presentation and relevant comorbidities. A diagnosis of benign recurrent intrahepatic cholestasis (BRIC) is also considered. |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Volume Number | 2013 |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | Open |
| Subject Keyword | Cholestasis Diagnosis Etiology Gallstones Complications Biopsy Cholangiopancreatography, Endoscopic Retrograde Cholangiopancreatography, Magnetic Resonance Cholecystectomy Therapy Diagnosis, Differential Liver Function Tests Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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