Open AccessDiagnostic challenges of Wilson’s disease presenting as acute pancreatitis, cholangitis, and jaundice
Author(s) -
Elchanan Nussinson,
Azmi Shahbari,
Fahmi Shibli,
Elena Chervinsky,
Philippe Trougouboff,
Arie Markel
Publication year - 2013
Publication title -
world journal of hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v5.i11.649
Subject(s) - medicine , gallstones , jaundice , pancreatitis , gastroenterology , endoscopic retrograde cholangiopancreatography , cholestasis , acute pancreatitis , abdominal pain , disease , general surgery
Wilson's disease is a rare disorder of copper transport in hepatic cells, and may present as cholestatic liver disease; pancreatitis and cholangitis are rarely associated with Wilsons's disease. Moreover, cases of Wilson's disease presenting as pigmented gallstone pancreatitis have not been reported in the literature. In the present report, we describe a case of a 37-year-old man who was admitted with jaundice and abdominal pain. The patient was diagnosed with acute pancreatitis, cholangitis, and obstructive jaundice caused by pigmented gallstones that were detected during retrograde cholangiopancreatography. However, because of his long-term jaundice and the presence of pigmented gallstones, the patient underwent further evaluation for Wilson's disease, which was subsequently confirmed. This patient's unique presentation exemplifies the overlap in the clinical and laboratory parameters of Wilson's disease and cholestasis, and the difficulties associated with their differentiation. It suggests that Wilson's disease should be considered in patients with pancreatitis, cholangitis, and severe protracted jaundice caused by pigmented gallstones.