RESUMO
INTRODUCTION: Bile duct involvement is a key finding of primary biliary cholangitis (PBC). The aim of this study was to evaluate baseline ductopenia and disease progression. METHODS: Retrospective longitudinal histological follow-up of treatment-naive patients with PBC. RESULTS: Eighty-three patients were included, with ductopenia correlated to fibrosis stage at baseline. The cumulative incidence of severe ductopenia remained stable after 5 years, whereas fibrosis continually increased over time. Baseline AST-to-Platelet Ratio Index and elevated alkaline phosphatase >2 times the normal with abnormal bilirubin were associated with ductopenia progression. DISCUSSION: Bile duct injury does not seem to follow the same course as fibrosis in PBC.
Assuntos
Colangite , Cirrose Hepática Biliar , Humanos , Cirrose Hepática Biliar/complicações , Cirrose Hepática Biliar/diagnóstico , Cirrose Hepática Biliar/epidemiologia , Estudos Retrospectivos , Ductos Biliares/diagnóstico por imagem , Ductos Biliares/patologia , Fibrose , Incidência , Colangite/diagnósticoRESUMO
Pancreatic tuberculosis (TB) warrants heightened suspicion in individuals with pancreatic lesions and risk factors such as HIV, organ transplantation, or pertinent immigration history. We present a 38-year-old man who presented with hemodynamically unstable gastrointestinal bleeding. He was found to have pancreatic TB complicated by a duodenal ulcer with fistula. Following 1 month of antitubercular therapy, he experienced complete resolution of symptoms, healing of the duodenal ulcer, closure of the fistulous tract, and a decrease in the size of the pancreatic lesion as observed on imaging. Our case highlights the importance of early diagnosis and treatment of pancreatic TB.
RESUMO
Sarcoidosis is a multisystemic disease which features non-necrotizing granulomas in lungs and other organs. Hepatic involvement in sarcoidosis varies between a mild asymptomatic disease and a progressive inflammatory granulomatous disease with or without cirrhosis. In this case presentation, we present a case of hepatic sarcoidosis complicated by clinically significant portal hypertension including splenomegaly and gastroesophageal varices successfully treated with immunosuppression to achieve portal hypertension reversal.