title: [A man in his thirties with icterus and itching].
abstract: BACKGROUND
  We present a patient from South-East Asia who has been living in Norway for five years. He was referred to our department with jaundice caused by opisthorchiasis/clonorchiasis. This reason for jaundice is highly unusual in Europe. Worldwide, however about 35,000,000 people are infected.
  
  
  METHODS
  A male in his thirties, originally from South-East Asia, experienced diffuse itching for five weeks and painless jaundice for two weeks. Blood samples showed increasing cholestasis. Abdominal ultrasound, MRCP and computed tomography showed no sign of bile duct obstruction or liver tumour. Serological tests and liver biopsy revealed no infectious or autoimmune liver disease. ERCP showed normal bile ducts, but large quantities of typical hookworms in the duodenum. Stool samples showed at least one egg typical of Opisthorchis/Clonorchis and a large quantity of hookworm eggs. We interpreted these findings as parasite-induced obstruction of some of the small bile ducts. The patient recovered completely after treatment with Praziquantel.
  
  
  CONCLUSIONS
  Jaundice due to bile duct obstruction by opisthorchiasis/clonorchiasis is a well-known problem in South-East Asia. It may become more common in Europe as well as a result of increasing migration. Treatment with Praziquantel is simple and effective.
authors.affiliation: Enhet for mage-tarm-sykdommer Medisinsk klinikk Sykehuset Telemark.
authors.forename: Gert
authors.initials: G
authors.lastname: Huppertz-Hauss
authors.affiliation: Enhet for mage-tarm-sykdommer Medisinsk klinikk Sykehuset Telemark.
authors.forename: Hanne
authors.initials: H
authors.lastname: Brekke
authors.affiliation: Infeksjonsseksjonen Medisinsk klinikk Sykehuset i Vestfold.
authors.forename: Marte
authors.initials: M
authors.lastname: Holmberg
authors.affiliation: Enhet for mage-tarm-sykdommer Medisinsk klinikk Sykehuset Telemark.
authors.forename: Hilde
authors.initials: H
authors.lastname: Skudal
mesh_terms: D000328:Adult; D000722:Ancylostoma / Q000302:isolation & purification; D000818:Animals; D000871:Anthelmintics / Q000627:therapeutic use; D001210:Asia, Southeastern / Q000208:ethnology; D001652:Bile Ducts / Q000469:parasitology; D003003:Clonorchiasis / Q000175:diagnosis / Q000188:drug therapy; D003004:Clonorchis sinensis / Q000254:growth & development / Q000302:isolation & purification*; D004386:Duodenum / Q000469:parasitology; D006801:Humans; D007565:Jaundice / Q000469:parasitology*; D008297:Male; D009664:Norway; D009889:Opisthorchiasis / Q000175:diagnosis / Q000188:drug therapy; D009891:Opisthorchis / Q000254:growth & development / Q000302:isolation & purification*; D011223:Praziquantel / Q000627:therapeutic use; D011537:Pruritus / Q000469:parasitology*
chemical_list: D000871:Anthelmintics; D011223:Praziquantel