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Ann Geriatr Med Res > Volume 21(3); 2017 > Article
Annals of Geriatric Medicine and Research 2017;21(3):138-141.
DOI: https://doi.org/10.4235/agmr.2017.21.3.138    Published online September 30, 2017.
Primary Sclerosing Cholangitis in an Elderly Patient: A Diagnostic Challenge
Tobar Marcillo Marco, Vela Vizcaino Hiram, Pliego Reyes Lenin
1Department of Internal Medicine, Regional Hospital “Licenciado Adolfo Lopez Mateos, Institute for Social Security and Services for State Workers”, Mexico City, Mexico. marcotobar1@hotmail.com
2National Autonomous University of Mexico, School of Medicine, Mexico City, Mexico.
Correspondence:  Tobar Marcillo Marco,
Email: marcotobar1@hotmail.com
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.
Key Words: Cholangitis, Sclerosing, Jaundice, Elderly
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