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Primary sclerosing cholangitis and Hodgkin's disease
K M Man1, A Drejet, E B Keeffe
1Department of Transplantation, California Pacific Medical Center, San Francisco 94115.
Insights
Primary sclerosing cholangitis (PSC) and Hodgkin's disease (HD) may co-occur, presenting a newly identified association. Symptoms of HD can be obscured by advanced PSC, complicating diagnosis and treatment.
Area of Science:
- Hepatology
- Oncology
- Gastroenterology
Background:
- Primary sclerosing cholangitis (PSC) is a chronic liver disease.
- Hodgkin's disease (HD) is a cancer of the lymphatic system.
- The association between PSC and HD is not well-established.
Observation:
- Three male patients with PSC and HD were identified.
- One patient also had Crohn's disease.
- PSC preceded HD diagnosis by 2, 11, and 17 years.
Findings:
- All patients had advanced biliary cirrhosis requiring liver transplant evaluation.
- HD symptoms were often masked by PSC manifestations, especially biliary sepsis.
- HD can occur in PSC patients, particularly with advanced liver disease.
Implications:
- This highlights a previously unrecognized association between PSC and HD.
- The overlapping symptoms may delay HD diagnosis in PSC patients.
- Awareness is crucial for early detection and management of HD in PSC patients.
Abstract:
Three patients with primary sclerosing cholangitis and Hodgkin's disease, a previously unrecognized association, are reported. All three patients were men, and one patient had Crohn's disease of the colon. Primary sclerosing cholangitis was diagnosed 2, 11 and 17 yr before diagnosis of Hodgkin's disease in the three patients, and all three had advanced biliary cirrhosis prompting referral for liver transplantation. The symptoms of Hodgkin's disease were often masked by similar manifestations of primary sclerosing cholangitis, particularly symptoms of recurrent biliary sepsis. Hodgkin's disease is another disorder that may occur in patients with primary sclerosing cholangitis, particularly in the setting of advanced disease, and may be masked by the underlying hepatobiliary disease.