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Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report

BACKGROUND: With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019 in Wuhan, China, liver injury in patients with coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection has been regularly reported in the literature. There are a growing number of publ...

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Autores principales: Steiner, Jakob, Kaufmann-Bühler, Ann-Katrin, Fuchsjäger, Michael, Schemmer, Peter, Talakić, Emina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827572/
https://www.ncbi.nlm.nih.gov/pubmed/36632122
http://dx.doi.org/10.4240/wjgs.v14.i12.1411
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author Steiner, Jakob
Kaufmann-Bühler, Ann-Katrin
Fuchsjäger, Michael
Schemmer, Peter
Talakić, Emina
author_facet Steiner, Jakob
Kaufmann-Bühler, Ann-Katrin
Fuchsjäger, Michael
Schemmer, Peter
Talakić, Emina
author_sort Steiner, Jakob
collection PubMed
description BACKGROUND: With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019 in Wuhan, China, liver injury in patients with coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection has been regularly reported in the literature. There are a growing number of publications describing the occurrence of secondary sclerosing cholangitis (SSC) after SARS-CoV-2 infection in various cases. We present a case of sudden onset SSC in a critically ill patient (SSC-CIP) following COVID-19 infection who was previously healthy. CASE SUMMARY: A 33-year old female patient was admitted to our University Hospital due to increasing shortness of breath. A prior rapid antigen test showed a positive result for SARS-CoV-2. The patient had no known preexisting conditions. With rapidly increasing severe hypoxemia she required endotracheal intubation and developed the need for veno-venous extracorporeal membrane oxygenation in a setting of acute respiratory distress syndrome. During the patient´s 154-d stay in the intensive care unit and other hospital wards she underwent hemodialysis and extended polypharmaceutical treatment. With increasing liver enzymes and the development of signs of cholangiopathy on magnetic resonance cholangiopancreatography (MRCP) as well as endoscopic retrograde cholangiopancreatography (ERCP), the clinical setting was suggestive of SSC. At an interdisciplinary meeting, the possibility of orthotopic liver transplantation and additional kidney transplantation was discussed due to the constant need for hemodialysis. Following a deterioration in her general health and impaired respiratory function with a reduced chance of successful surgery and rehabilitation, the plan for transplantation was discarded. The patient passed away due to multiorgan failure. CONCLUSION: SSC-CIP seems to be a rare but serious complication in patients with SARS-CoV-2 infection, of which treating physicians should be aware. Imaging with MRCP and/or ERCP seems to be indicated and a valid method for early diagnosis. Further studies on the effects of early and late SSC in (post-) COVID-19 patients needs to be performed.
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spelling pubmed-98275722023-01-10 Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report Steiner, Jakob Kaufmann-Bühler, Ann-Katrin Fuchsjäger, Michael Schemmer, Peter Talakić, Emina World J Gastrointest Surg Case Report BACKGROUND: With the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019 in Wuhan, China, liver injury in patients with coronavirus disease 2019 (COVID-19) due to SARS-CoV-2 infection has been regularly reported in the literature. There are a growing number of publications describing the occurrence of secondary sclerosing cholangitis (SSC) after SARS-CoV-2 infection in various cases. We present a case of sudden onset SSC in a critically ill patient (SSC-CIP) following COVID-19 infection who was previously healthy. CASE SUMMARY: A 33-year old female patient was admitted to our University Hospital due to increasing shortness of breath. A prior rapid antigen test showed a positive result for SARS-CoV-2. The patient had no known preexisting conditions. With rapidly increasing severe hypoxemia she required endotracheal intubation and developed the need for veno-venous extracorporeal membrane oxygenation in a setting of acute respiratory distress syndrome. During the patient´s 154-d stay in the intensive care unit and other hospital wards she underwent hemodialysis and extended polypharmaceutical treatment. With increasing liver enzymes and the development of signs of cholangiopathy on magnetic resonance cholangiopancreatography (MRCP) as well as endoscopic retrograde cholangiopancreatography (ERCP), the clinical setting was suggestive of SSC. At an interdisciplinary meeting, the possibility of orthotopic liver transplantation and additional kidney transplantation was discussed due to the constant need for hemodialysis. Following a deterioration in her general health and impaired respiratory function with a reduced chance of successful surgery and rehabilitation, the plan for transplantation was discarded. The patient passed away due to multiorgan failure. CONCLUSION: SSC-CIP seems to be a rare but serious complication in patients with SARS-CoV-2 infection, of which treating physicians should be aware. Imaging with MRCP and/or ERCP seems to be indicated and a valid method for early diagnosis. Further studies on the effects of early and late SSC in (post-) COVID-19 patients needs to be performed. Baishideng Publishing Group Inc 2022-12-27 2022-12-27 /pmc/articles/PMC9827572/ /pubmed/36632122 http://dx.doi.org/10.4240/wjgs.v14.i12.1411 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
spellingShingle Case Report
Steiner, Jakob
Kaufmann-Bühler, Ann-Katrin
Fuchsjäger, Michael
Schemmer, Peter
Talakić, Emina
Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report
title Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report
title_full Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report
title_fullStr Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report
title_full_unstemmed Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report
title_short Secondary sclerosing cholangitis in a young COVID-19 patient resulting in death: A case report
title_sort secondary sclerosing cholangitis in a young covid-19 patient resulting in death: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827572/
https://www.ncbi.nlm.nih.gov/pubmed/36632122
http://dx.doi.org/10.4240/wjgs.v14.i12.1411
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