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Case report: intrahepatic cholestasis: a diagnostic dilemma

Abstract:

Cholestasis is an impairment of bile formation or bile flow. The mechanisms of cholestasis can be broadly classified into intrahepatic and extrahepatic. Most of the time, etiology can be determined with proper history, physical examination, and diagnostic testing including laboratory and imaging tests. This is a case report of a patient with severe cholestasis who underwent extensive evaluation to determine the etiology of intrahepatic cholestasis.

This Case Report details a 28-year-old male who presented with seven days’ history of yellowish discoloration of eyes, the passage of dark-colored urine, generalized body itching, and the passage of clay-colored stool. The patient had no similar episode in the past. Laboratory investigations showed unconjugated hyperbilirubinemia and increased alkaline phosphatase. Magnetic resonance cholangiopancreaticography was unremarkable and liver biopsy was suggestive of cholestatic pattern and negative for acute hepatitis. The bilirubin level started decreasing after a month.

The etiology of intrahepatic cholestasis remained unknown. Genotyping could not be done due to limited available resources. It may have helped to diagnose familial hepatocellular cholestasis such as benign recurrent intrahepatic cholestasis (BRIC) and progressive familial intrahepatic cholestasis. Gamma-glutamyl transferase is normal or mildly elevated in patients with BRIC. A similar picture was seen in our case as well. If the patient presents again with similar symptoms and findings, we can consider the diagnosis of BRIC.

Publication status:
Published
Peer review status:
Under review

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Publisher copy:
10.12688/wellcomeopenres.19381.2

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Role:
Author
ORCID:
0009-0005-8294-0382
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Role:
Author
ORCID:
0000-0003-4830-3177
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Role:
Author
ORCID:
0000-0001-6343-7515
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Role:
Author
ORCID:
0000-0003-2659-3425


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Funder identifier:
https://ror.org/029chgv08
Grant:
106680


Publisher:
Taylor and Francis
Journal:
Wellcome Open Research More from this journal
Volume:
8
Article number:
226
Publication date:
2023-05-24
DOI:
EISSN:
2398-502X
ISSN:
2398-502X
Pmid:
39600379


Language:
English
Keywords:
Pubs id:
2070854
Local pid:
pubs:2070854
Deposit date:
2025-02-14
ARK identifier:

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