Reversible sclerosing cholangitis with ulcerative colitis.
Reversible sclerosing cholangitis with ulcerative colitis.
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可逆性硬化性胆管炎合并溃疡性结肠炎。
DOI：
10.1111/pin.12427
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发表时间：
2016
期刊：
影响因子：
--
通讯作者：
Takikawa Y
中科院分区：
文献类型：
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作者：
Kakisaka K;Ishida K;Kataoka K;Suzuki Y;Yanai S;Kuroda H;Sugai T;Matsumoto T;Takikawa Y
硬化性胆管炎（SC）伴粒细胞上皮病变（GEL）对免疫抑制治疗反应良好。我们治疗了一位患有溃疡性结肠炎的42岁日本女性，她入院接受进一步的碱性磷酸酶水平升高和肝内胆管扩张的评估。住院第4天的肝活检显示中性粒细胞浸润到胆管上皮，诊断为GEL。由于她的溃疡性结肠炎处于活跃期，因此开始使用强的松龙治疗。服用PSL后，实验室数据显著减少。入院第66天行肝活检以确认门静脉胆管周围病变。给药后，中性粒细胞向胆管上皮的浸润消失，肝脏中未发现IgG4阳性浆细胞。在此，我们报告了一例罕见的凝胶阳性SC病例。本病例提供了免疫抑制治疗过程中治疗诱导的组织学改变以及生化数据的一系列变化的早期证据。
Sclerosing cholangitis (SC) with granulocytic epithelial lesion (GEL) responds well to immunosuppression therapy. We treated a 42‐year‐old Japanese female with ulcerative colitis, who was admitted for further evaluation of both an elevated alkaline phosphatase level and dilated intrahepatic bile ducts. A liver biopsy on the fourth hospital day revealed the infiltration of neutrophils into the bile duct epithelium, which was diagnosed as GEL. Because her ulcerative colitis was in an active stage, prednisolone (PSL) therapy was started. After the administration of PSL, laboratory data dramatically decreased. A liver biopsy was performed on the 66th hospital day to confirm the lesion around bile ducts in the portal tract. The infiltration of neutrophils into the bile duct epithelium disappeared after PSL administration, and IgG4‐positive plasma cells were not found in the liver. Herein, we report a rare case of GEL‐positive SC. The present case provides early evidence of treatment‐induced histological changes as well as serial changes in biochemical data during the course of immunosuppression therapy.