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A Case of Unexplained Cutaneous Lesions, Cholestatic Hepatitis, and Noncirrhotic Portal Hypertension in a Female Patient

2020-10Journal article Open access
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dc.contributor.authorCarvão, Joana
dc.contributor.authorPereira, Vítor Magno
dc.contributor.authorJasmins, Luís
dc.date.accessioned2020-12-09T10:44:00Z
dc.date.available2020-12-09T10:44:00Z
dc.date.issued2020-10
dc.description.abstractQuestion: A 57-year old woman with a previous history of contrast-related anaphylaxis was referred to the gastroenterology department with worsening liver function tests. She developed recurrent abdominal pain, diarrhea, significant weight loss, pruriginous generalized skin rash, and increased abdominal volume over 1 year. Physical examination revealed generalized small reddish monomorphic macules on the trunk and thighs (Figure A), hepatosplenomegaly, peripheral lymphadenopathy, and ascites. Blood tests showed normocytic normochromic anemia (hemoglobin 9.4 g/dL), monocytosis (1.3 103/mL), thrombocytopenia (97 103/mL), slight international normalized ratio prolongation, and a marked elevation of cholestasis parameters without jaundice (aspartate aminotransferase, 60 U/L; alanine aminotransferase, 56 U/L; gamma-glutamyl transferase, 324 U/L; and alkaline phosphatase, 1277 U/L). Abdominal Doppler ultrasound examination and a computed tomography scan revealed homogeneous hepatosplenomegaly (without signs of chronic liver disease), signs of portal hypertension without thrombosis of the splenoportal axis, moderate ascites, and intra-abdominal, axillary, and inguinal lymphadenopathies. Upper endoscopy showedesophageal varices and portal hypertensive gastropathy.Laboratory studies for chronic hepatopathy, infectious agents, and angiotensin-converting enzyme were negative. Bone marrow biopsy revealed granulomatous myelitis, and both lymphadenopathy and skin biopsies showed increased mononuclear cells.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationA case of unexplained cutaneous lesions, cholestatic hepatitis and Noncirrhotic Portal Hypertension in a Female Patient. Carvão j.Pereira VM, Jasmins, l- Gastroenterology, 2020pt_PT
dc.identifier.doi10.1053/j.gastro.2020.03.076pt_PT
dc.identifier.issn0016-5085
dc.identifier.urihttp://hdl.handle.net/10400.26/34288
dc.language.isoengpt_PT
dc.publisherAGA Institutept_PT
dc.subjectcutaneous lesionspt_PT
dc.subjectepatitispt_PT
dc.subjectnon cirrhotic portal hypertension(GRAIL)pt_PT
dc.subjectMadeira Islandpt_PT
dc.subjectPortugalpt_PT
dc.titleA Case of Unexplained Cutaneous Lesions, Cholestatic Hepatitis, and Noncirrhotic Portal Hypertension in a Female Patientpt_PT
dc.title.alternativeELECTRONIC CLINICAL CHALLENGES AND IMAGES IN GIpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPagee15pt_PT
oaire.citation.issue4pt_PT
oaire.citation.startPagee13pt_PT
oaire.citation.titleGastroenterologypt_PT
oaire.citation.volume159pt_PT
person.familyNameCarvão
person.familyNamePereira
person.givenNameJoana
person.givenNameVítor
person.identifier.orcid0000-0003-2063-4257
person.identifier.orcid0000-0002-9854-086X
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublicationb88aa96c-a700-4e04-ae29-ca3c54dba663
relation.isAuthorOfPublication206b8104-6d62-49eb-ac05-5649bcc1b4b6
relation.isAuthorOfPublication.latestForDiscoveryb88aa96c-a700-4e04-ae29-ca3c54dba663

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