Secondary Sclerosing Cholangitis in Critically Ill Patients: a Rare Disease Precipitated by Severe SARS-CoV-2 Infection

Overview

Journal BMJ Case Rep

Specialty General Medicine

Date 2020 Nov 10

PMID 33168538

Citations 35

Authors

Kate Edwards

Miles Allison

Sekina Ghuman

Affiliations

Soon will be listed here.

Abstract

A previously well 59-year-old man required a prolonged intensive care unit stay due to severe COVID-19 symptoms. During the admission, he developed a cytokine storm, also known as secondary haemophagocytic lymphohistocytosis, and multiorgan failure. Despite recovering from his other organ failures, his liver function continued to deteriorate. Magnetic resonance cholangiopancreatography and subsequent endoscopic retrograde cholangiopancreatography revealed extensive intrahepatic duct dilatation with 'beading' but common bile duct sparing. Given the patient had no primary liver disease prior to admission, we considered secondary causes of cholestatic liver injury; this led us to an unusual diagnosis of secondary sclerosing cholangitis in critically ill patients. This case demonstrates a rare disease that has developed specifically in the context of SARS-CoV-2 infection. A review of current literature and the underlying pathophysiology for this rare disease are discussed, particularly in relation to COVID-19.

Citing Articles

Incidence of Secondary Sclerosing Cholangitis in Hospitalized Long COVID-19 Patients: A Retrospective Single Center Study.

Werner C, Fusco S, Kienzle K, Dobele S, Artzner K, Malek N Diagnostics (Basel). 2024; 14(7).

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Post-COVID-19 Cholangiopathy: Clinical and Radiologic Findings.

Kim H, Lee S Korean J Radiol. 2023; 24(11):1167-1171.

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Clinical and Histopathological Discoveries in Patients with Hepatic Injury and Cholangiopathy Who Have Died of COVID-19: Insights and Opportunities for Intervention.

Lim J, Njei B Hepat Med. 2023; 15:151-164.

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Secondary Sclerosing Cholangitis After SARS-CoV2: ICU Ketamine Use or Virus-Specific Biliary Tropism and Injury in the Context of Biliary Ischemia in Critically Ill Patients?.

Bartoli A, Cursaro C, Seferi H, Andreone P Hepat Med. 2023; 15:93-112.

PMID: 37547355 PMC: 10404108. DOI: 10.2147/HMER.S384220.

Coronavirus Disease in the Abdomen.

Anderson M, Khauli M, Goiffon R, Kambadakone A Adv Clin Radiol. 2023; 4(1):25-35.

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