ABSTRACT
BACKGROUND: The association between ulcerative colitis (UC) and primary sclerosing cholangitis has been described for several years and can be classified as having a distinct disease phenotype from inflammatory bowel diseases (IBD). The simultaneous occurrence of decompensated liver disease requiring liver transplant and active IBD is a management challenge, considering that these patients may be at increased risk of infections, thromboembolic events, bleeding, and drug hepatotoxicity. CASE PRESENTATION: We describe a case of a 37-year-old patient with UC and sclerosing cholangitis presenting with severe decompensated rectocolitis complicated with thromboembolic phenomena and severe liver dysfunction who underwent liver transplant while using biological therapy to control bowel disease. CONCLUSIONS: This case highlights the evolution of sclerosing cholangitis to liver transplant in patients with decompensated UC. Despite the risk of recurrence, primary sclerosing cholangitis has excellent results after liver transplant. Despite the use of immunosuppression after liver transplant, biological therapy may be necessary to control IBD.
Subject(s)
Cholangitis, Sclerosing , Colitis, Ulcerative , Inflammatory Bowel Diseases , Liver Diseases , Liver Transplantation , Cholangitis, Sclerosing/complications , Cholangitis, Sclerosing/surgery , Colitis, Ulcerative/complications , Colitis, Ulcerative/surgery , Humans , Inflammatory Bowel Diseases/complications , Liver Diseases/complications , Liver Transplantation/adverse effectsABSTRACT
Os autores relatam o atendimento e evoluçäo de uma criança com constipaçäo intestinal crônica funcional dentro de um projeto de pesquisa sobre psicossomática na criança por um período de um ano e meio em dezessete atendimentos. Chamam a atençäo para o papel da relaçäo médico-mäe-criança na transformaçäo das relaçöes familiares, que tem como consequência o desaparecimento dos sintomas. Näo se trata de um relato raro, mas uma nova abordagem clínica
