title: Cholestatic jaundice and bone lesions in an elderly woman.
abstract: 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).
authors.affiliation: University of Pittsburgh Medical Center, PA, USA.
authors.forename: Georgios I
authors.initials: GI
authors.lastname: Papachristou
authors.forename: Anthony J
authors.initials: AJ
authors.lastname: Demetris
authors.forename: Fiona
authors.initials: F
authors.lastname: Craig
authors.forename: Kenneth K W
authors.initials: KK
authors.lastname: Lee
authors.forename: Mordechai
authors.initials: M
authors.lastname: Rabinovitz
mesh_terms: D000368:Aged; D001847:Bone Diseases / Q000209:etiology*; D005260:Female; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology*; D034721:Mastocytosis, Systemic / Q000150:complications* / Q000473:pathology