Cholestatic jaundice and bone lesions in an elderly woman.
BACKGROUND
A 74-year-old Caucasian female presented with jaundice, clay-colored stools, diarrhea, and fatigue of 3 months' duration, accompanied by a weight loss of 6.8 kg. Physical examination demonstrated mild hepatomegaly. Initial blood work revealed abnormal liver biochemistries with a cholestatic pattern. An abdominal CT scan showed intrahepatic bile-duct dilatation without masses but with multiple lytic and blastic bone lesions. A sacral bone biopsy established the diagnosis.


METHODS
Endoscopic ultrasound, endoscopic retrograde cholangiopancreatography, CT scan, bone biopsy and liver biopsy.


METHODS
Systemic mastocytosis affecting the biliary system resulting in a primary-sclerosing-cholangitis-like picture combined with diffuse blastic and lytic bone lesions.


RESULTS
Biliary stenting, histamine 1- and 2-receptor blockers, and chemotherapy (cladribine).
Papachristou
Georgios I
GI
University of Pittsburgh Medical Center, PA, USA.
Demetris
Anthony J
AJ
Craig
Fiona
F
Lee
Kenneth K W
KK
Rabinovitz
Mordechai
M
D000368:Aged; D001847:Bone Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D034721:Mastocytosis, Systemic / Q000150:complications* / Q000473:pathology