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Published on: September 27, 2019
A Child with Debilitating Pruritus
Nikhil Sonthalia1, Samit S Jain1, Vinay B Pawar1
1Department of Gastroenterology; Topiwala National Medical College and BYL Nair Ch Hospital , Mumbai, Maharashtra, India.
Insights
A rare case of progressive familial intrahepatic cholestasis type I (PFIC I) in a two-year-old boy was successfully managed with medical therapy. This Indian case highlights diagnostic and therapeutic challenges in treating this rare liver disorder.
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Medical Genetics
Background:
- Progressive familial intrahepatic cholestasis type I (PFIC I) is a rare genetic disorder affecting bile flow.
- Early diagnosis and management are crucial for improving patient outcomes.
- Limited case reports exist, particularly from India, necessitating further documentation.
Abstract:
We describe a case of two-year-old boy presenting with debilitating pruritus, patchy alopecia and jaundice since the age of 6 months. On evaluation he had intrahepatic cholestasis with persistently raised serum alkaline phosphatase, normal Gamma glutamyl transferase and raised serum bile acid levels. His liver biopsy showed bland cholestasis and electron microscopy showed granular bile suggestive of progressive familial intrahepatic cholestasis type I. Medical therapy with ursodeoxycholic acid, cholestyramine, rifampicin with nutritional modification was successful in alleviating the symptoms and correcting the nutritional status. To our knowledge this is only the sixth case of progressive familial intrahepatic cholestasis type I reported from India. Herein we discuss the diagnostic and therapeutic hurdles that one encounters in managing progressive familial intrahepatic cholestasis and also review the literature regarding this rare disorder.
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