Ann Geriatr Med Res.  2017 Sep;21(3):138-141. 10.4235/agmr.2017.21.3.138.

Primary Sclerosing Cholangitis in an Elderly Patient: A Diagnostic Challenge

• Marco TM
• Hiram VV
• Lenin PR

• KMID: 2393090
• DOI: http://doi.org/10.4235/agmr.2017.21.3.138

Abstract

Jaundice syndrome is a diagnostic challenge for physicians. It must be diagnosed based on its etiology, which depends on liver function test results, clinical manifestations, and age of presentation, and the objective is to rule out the most common causes and then the rare causes. We describe the case of a male patient aged 86 years who had jaundice and was diagnosed as having primary sclerosing cholangitis based on liver biopsy findings. It is a chronic, progressive cholestatic liver disease with unknown etiology until now. Primary sclerosing cholangitis is characterized by inflammation, fibrosis, and stenosis of small, medium, and large intrahepatic and extrahepatic biliary ducts. Although it is a rare entity in geriatric patients, certain characteristics are infrequently considered in clinical practice; thus, considering all characteristics of this disease would help physicians make the diagnosis earlier. It is a condition that should be considered when jaundice is associated with pruritus and elevated levels of peripheral eosinophils and immunoglobulin E.

Keyword

Cholangitis; Sclerosing; Jaundice; Elderly

MeSH Terms

Aged*
Biopsy
Cholangitis
Cholangitis, Sclerosing*
Constriction, Pathologic
Diagnosis
Eosinophils
Fibrosis
Humans
Immunoglobulin E
Immunoglobulins
Inflammation
Jaundice
Liver
Liver Diseases
Liver Function Tests
Male
Pruritus
Immunoglobulin E
Immunoglobulins