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A case of secondary sclerosing cholangitis due to COVID-19
Shima Tafreshi1, Ian Whiteside2, Irving Levine3
1NSLIJ Northwell Health System, Department of Radiology, 300 Community Drive, Manhasset, NY 11030, United States.
Insights
This case study highlights biliary damage as a rare complication of Coronavirus Disease 2019 (COVID-19). Imaging is crucial for diagnosing this multisystemic manifestation, which can lead to severe liver issues.
Area of Science:
- Hepatology
- Virology
- Gastroenterology
Background:
- Coronavirus Disease 2019 (COVID-19), a global pandemic, primarily affects the respiratory system.
- Emerging evidence indicates COVID-19 can cause multisystemic manifestations, including liver injury.
Observation:
- A previously healthy patient developed severe complications after contracting COVID-19 in March 2020.
- The patient experienced a complicated disease course requiring intubation and multiple hospital readmissions.
- Chronic abdominal pain was a persistent symptom following the initial infection.
Findings:
- The patient presented with significant liver damage, evidenced by elevated AST and ALT levels.
- A rare complication of biliary damage was observed, distinct from typical pulmonary symptoms.
- Imaging studies played a critical role in diagnosing the biliary injury.
Implications:
- This case suggests biliary damage is a potential, albeit rare, complication of COVID-19.
- The findings underscore the importance of considering non-pulmonary manifestations of COVID-19.
- Early diagnosis through imaging may be vital for managing COVID-19-related liver complications and potential liver transplant needs.
Abstract:
COVID-19 was first recognized by the World Health Organization (WHO) in December 2019 and declared a global pandemic in March 2020. Although COVID-19 primarily results in pulmonary symptoms, it is becoming apparent that it can lead to multisystemic manifestations. Liver damage with elevated AST and ALT is seen in patients with COVID-19. Although the etiology of liver damage is still debated, biliary damage is rarely seen. This case demonstrates a potential complication of COVID-19 in a previously healthy patient. The patient contracted COVID-19 in March 2020 and endured a complicated course including intubation, multiple readmissions, and chronic abdominal pain. He is now awaiting a liver transplant. Our case portrays biliary damage as an additional possible complication of COVID-19 and the importance of imaging in its diagnosis.
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