Buy (150 RUB)
Generate QR code
Open Access
Subscription or Fee Access
Primary sclerosing cholangitis. A clinical case
https://doi.org/10.33667/2078-5631-2025-13-52-56
Abstract
A clinical case of an 18-year-old patient with primary sclerosing cholangitis, observed from 2021 to 2025, was analyzed. Condition after retrograde bile duct endoprosthetics, laparoscopic cholecystectomy. In 2021, after a new coronavirus infection, the level of total bilirubin, ALAT, GGT and ALP activity increased for the first time. After examination, the following diagnosis was made: Cholestatic hepatitis with a moderate degree of activity against the background of stenosis of the common bile duct. Cholangitis. Biliary sludge. Symptomatic therapy was prescribed. A year later, the condition was unchanged. Retrograde endoprosthetics of the bile ducts was performed, after which the condition improved, the biochemical parameters returned to normal. After 3 months, the stent was removed using a loop. An increase in GGT levels was noted again. A puncture biopsy was performed. Histologically: The degree of fibrosis according to the METAVIR scale is F3. The diagnosis was made: Chronic cholangitis. Condition after stenting. Most likely, the onset of primary sclerosing cholangitis (PSC). A year later, the diagnosis was made: Chronic active hepatitis. Primary sclerosing cholangitis, fibrosis stage F3 according to the METAVIR scale. Therapy was prescribed. The patient is currently under observation and treatment.
About the Authors
O. V. Churbakova
Samara State Medical University
Russian Federation
Russian Federation
Churbakova Olga V., DM Sci (habil.), associate professor at Dept of Children's Diseases
Samara
V. V. Makashova
Central Research Institute of Epidemiology of Rospotrebnadzor
Russian Federation
Russian Federation
Makashova Vera V., DM Sci (habil.), professor, leading researcher at Clinical Dept of Infectious Pathology
Moscow
D. V. Pechkurov
Samara State Medical University
Russian Federation
Russian Federation
Pechkurov Dmitry V., DM Sci (habil.), professor, head of Dept of Children's Diseases
Samara
E. Yu. Shilova
Samara City Hospital No. 6
Russian Federation
Russian Federation
Shilova Elena Yu., pediatrician, head of Pediatric Dept of Children's Outpatient Dept № 1
Samara
Yu. V. Savostina
Samara City Hospital No. 6
Russian Federation
Russian Federation
Savostina Yulia V., pediatrician, district doctor at Children's Outpatient Dept № 1
Samara
V. G. Akimkin
Central Research Institute of Epidemiology of Rospotrebnadzor
Russian Federation
Russian Federation
Akimkin Vasily G., RAS academician, DM Sci (habil.), professor, director
Moscow
References
1. Volynets G.V., Nikitin A.V. Cholestatic diseases in children: a monograph. Moscow: OOO «OPPONENT». 2020. 240 p. (In Russ.).
2. Smolka V., Karaskova E., Tkachyk O. et al. Long-term follow-up of children and adolescents with primary sclerosing cholangitis and autoimmune sclerosing cholangitis. Hepatobiliary Pancreat Dis Int. 2016;15(4).
3. Volynets G.V., Khavkin A.I., Skvortsova T.A., Matkash V.V., Nikitin A.V. Sclerosing cholangitis in children and adolescents: the current state of the problem. Russian Pediatric Journal. 2018; 21(5): 312–318. (In Russ.).
4. Goryainova A.N., Antsupova M.A., Karaseva L.N. and others. Cholestasis (cholestatic hyperbilirubinemia) in newborns and young children: definition, causes, differential diagnosis, conservative therapy. Effective pharmacotherapy. 2019; 15 (21): 24–35. (In Russ.).
5. Efremova N.A., Goryacheva L.G., Rogozina N.V., Alekseeva L.A., Kotiv M. Ya. Clinical and laboratory features of neonatal hepatitis of various etiologies. Childhood infections. 2012; 2: 8–10. (In Russ.).
6. Infectious diseases in children: a textbook for pediatric faculties of medical universities. Edited by prof. V.N. Timchenko.– 4th ed., ispr. and add. St. Petersburg: SpetsLit, 2012; 623 p. (In Russ.).
7. Infectious diseases: national guidelines. Edited by N.D. Yushchuk, Yu. Ya. Vengerov. Moscow: GEOTAR-Media, 2021. (In Russ.).
8. Valentino P.V., Kamath B.M. Liver Disease in Pediatric Inflammatory Bowel Disease. Pediatric Inflammatory Bowel Disease. Springer, 2013; 95–104.
9. Kamalova A. A., Gayfutdinova A. R., Malov A. A., Safina E. R., Nizamova R. A., Basanova L.I. Primary sclerosing cholangitis in inflammatory bowel diseases in children. Vestn. Perinatol. and the pediatrician, 2021; 66 (5): 150–156. (In Russ.).
10. Usoltseva O.V., Surkov A.N., Movsisyan G.B., Kulebina E.A., Simerzina S.A., Potapov A.S., Lokhmatov M.M. Primary sclerosing cholangitis in children with inflammatory bowel diseases. Russian Pediatric Journal. 2021; 24 (6): 395–404. (In Russ.).
11. Gafur S., Hermann M., Jungst K., Müllhaupt B., Cäcilia S. Rainer& Daniel Stocker Merkmale der mit COVID 19 verbundenen sekundären sklerosierenden Cholangitis bei der Magnetresonanz-Cholangiopankreatographie: retrospektive Analyse. Insights Imaging. 2022; 13: 128.
12. Ду М., Янг С., Лю М., Лю Дж. COVID 19 и дисфункция печени: эпидемиология, связь и потенциальные механизмы. Clin Res Hepatol Gastroenterol. 2022; 46 (2):101793.
13. Absandze K.G., Vinnitskaya E.V., Sandler Yu.G., Sbikina E. S., Shkurko T.V. Primary biliary cholangitis – has the problem been solved? Therapist's Bulletin. 2019; 6–7: 42–43. (In Russ.).
14. Chapman M., Thorburn D., Hirschfield D., Webster G., Rushbrook S., Alexander G, Collier J., Dyson J.., Jones D., Patanwala I., Thain С., Walmsley М., Pereira S. British Society of Gastroenterology and UK-PSC guidelines for the diagnosis and management of primary sclerosing cholangitis. Gut. 2019; 68 (8): 1356–1378.
15. Boberg K. M., Chapman R.W., Hirschfield G. M. Overlap syndromes: The international autoimmune hepatitis group (IAIHG) position statement on a controversial issue on behalf of the International Autoimmune Hepatitis Group. Journal of Hepatology. 2011; 54 (2): 374–385.
16. Vinnitskaya E.V., Abdulkhakov S.R., Abdurakhmanov D.T., Alikhanov R.B., Bakulin I.G. and others. Current issues of diagnosis and treatment of primary sclerosing cholangitis (based on the materials of the Russian Consensus on the diagnosis and Treatment of primary sclerosing cholangitis. Moscow, 2018). Therapeutic Archive. 2019; 91 (2): 9–15. (In Russ.).
17. Pak E. S., Petrova T.M., Korobka R.V., Ushakov A.A., Kucherenko O.B., Kotsiyaev V. Yu., Bukhtin O.V. Recurrence of primary sclerosing cholangitis in graft. Medical Bulletin of the South of Russia. 2024; 15 (3): 97–105. (In Russ.).
18. Syutkin V.E., Salienko A.A., Olisov O.D., Novruzbekov M.S. The return of autoimmune diseases after liver transplantation. Transplantation. 2022; 14 (4): 421–431. (In Russ.).
19. Korobka V. L., Pasechnikov V. D., Korobka R. V., Pak E. S., Shapovalov A. M. The use of endoscopic ligation of varicose veins in combination with non-selective beta-blockers, or independently, in the prevention of bleeding in patients with ascites included in the waiting list for liver transplantation. Bulletin of Transplantology and artificial Organs. 2022; 24 (3): 42–50. (In Russ.).
20. Mayevskaya M.V., Nadinskaya M. Yu., Lunkov V.D., Pirogova I. Yu., Chesnokov E.V., Kodzoeva H.B., Ivashkin V. T. The effect of ursodeoxycholic acid on inflammation, steatosis and fibrosis of the liver and atherogenesis factors in patients with non-alcoholic fatty liver disease: the results of the SUCCESS study. Russian Journal of Gastroenterology, Hepatology, and Coloproctology. 2019; 29 (6): 22–29. (In Russ.).
Review
For citations:
Churbakova O.V., Makashova V.V., Pechkurov D.V., Shilova E.Yu., Savostina Yu.V., Akimkin V.G. Primary sclerosing cholangitis. A clinical case. Medical alphabet. 2025;(13):52-56. (In Russ.) https://doi.org/10.33667/2078-5631-2025-13-52-56
Views:
22
Email this article 