Premium
Auto‐immune cholangiopathy in a juvenile patient with systemic lupus erythematosus
Author(s) -
NobleJamieson Gabriele,
Jayne David,
Hook Elizabeth
Publication year - 2012
Publication title -
acta paediatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.2012.02611.x
Subject(s) - medicine , jaundice , cholestasis , gastroenterology , liver biopsy , immune system , transaminase , immunology , biopsy , biochemistry , chemistry , enzyme
Systemic lupus erythematosus (SLE) is a multi‐system inflammatory disease characterized by the presence of auto‐antibodies. Liver enzyme abnormalities are common but clinical liver dysfunction with jaundice is rare. We report a juvenile female patient with SLE who developed jaundice 9 months after her initial presentation. Further investigations including liver biopsy and magnetic resonance cholangio‐pancreatography revealed two likely pathologies for her liver dysfunction; amoxicillin‐clavulanic acid induced cholestasis and auto‐immune cholangiopathy. The hyperbilirubinaemia resolved spontaneously 3 months after exposure to amoxicillin‐clavulanic acid; however, the elevation in Alanine transaminase and Gamma‐glutamyl transpeptidase persisted until intensive immunosuppressive therapy achieved complete remission. Conclusion: We report a rare case of a juvenile patient with SLE and auto‐immune cholangiopathy. The use of cholangio‐pancreatography as part of the diagnostic work‐up achieved the final diagnosis.