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Reversible sclerosing cholangitis secondary to cryptosporidiosis in a renal transplant patient.

Abstract
Cryptosporidium parvum is a well-known cause of chronic diarrhea. In human immunodeficiency virus (HIV)-infected patients as well as in other immunocompromised patients it has also been shown to cause sclerosing cholangitis. We report a case of reversible C. parvum-induced sclerosing cholangitis in a renal transplant patient. This 40-year-old female received a renal transplant 9 years prior to presentation. She had no history of liver disease and was doing well on tacrolimus, prednisone, and azathioprine. She developed diarrhea and was found to have C. parvum present in the stool. Shortly after, she developed clinical, biochemical, radiologic, and histologic features of SC. After accidental reduction in her immunesuppression secondary to starting her on rifampin to treat her itching, she cleared C. parvum from her stool and had a marked improvement in her diarrhea, jaundice, and general health. Her liver enzymes normalized and magnetic resonance cholangiography showed complete resolution of biliary abnormalities. To our knowledge, this is the first case of C. parvum-induced sclerosing cholangitis in a renal transplant patient and one of a few in non-HIV patients. It is also the first to document resolution of sclerosing cholangitis after eradication of C. parvum in a non-HIV patient.
AuthorsAyman Abdo, John Klassen, Stefan Urbanski, Earl Raber, Mark G Swain
JournalJournal of hepatology (J Hepatol) Vol. 38 Issue 5 Pg. 688-91 (May 2003) ISSN: 0168-8278 [Print] Netherlands
PMID12713884 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Immunosuppressive Agents
Topics
  • Adult
  • Animals
  • Cholangitis, Sclerosing (parasitology)
  • Cryptosporidiosis (complications, therapy)
  • Cryptosporidium parvum
  • Female
  • Humans
  • Immunosuppressive Agents (administration & dosage)
  • Kidney Transplantation

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