jaundice cholestatic;
endoscopic retrograde cholangiopancreatography (ercp);
magnetic resonance cholangiopancreatography (mrcp);
lack of health insurance;
social determinants of health (sdoh);
inflammatory bowel disease;
ulcerative colitis (uc);
primary sclerosing cholangitis (psc);
D O I:
10.7759/cureus.45311
中图分类号:
R5 [内科学];
学科分类号:
1002 ;
100201 ;
摘要:
Primary sclerosing cholangitis (PSC) is a rare type of autoimmune hepatic disease with unknown pathophysiology, often a sequela of ulcerative colitis (UC). Liver transplant, though curative, is inaccessible to many patients due to stringent organ availability and barriers to sufficient insurance coverage. Low health literacy and low socioeconomic class can significantly limit healthcare access and thus worsen overall healthcare outcomes. Here, we present the case of an uninsured 49-year-old man with untreated UC who was diagnosed with PSC and subsequently became lost to follow-up. It is critical for providers to identify barriers to acquiring appropriate medical care, such as financial instability and low health literacy, when identifying and treating conditions like PSC. Moreover, more research should be performed to investigate alternative treatments for PSC.
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Ctr Digest Dis, Div Coloproctol, Stockholm, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Nordenvall, Caroline
Olen, Ola
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Clin Epidemiol Unit, Dept Med Solna, Stockholm, Sweden
Sachs Childrens Hosp, Dept Pediat Gastroenterol & Nutr, Stockholm, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Olen, Ola
Nilsson, Per Johan
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Ctr Digest Dis, Div Coloproctol, Stockholm, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Nilsson, Per Johan
Ekbom, Anders
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h-index: 0
机构:
Karolinska Inst, Clin Epidemiol Unit, Dept Med Solna, Stockholm, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Ekbom, Anders
Bottai, Matteo
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Unit Biostat, Inst Environm Med, Stockholm, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Bottai, Matteo
Myrelid, Par
论文数: 0引用数: 0
h-index: 0
机构:
Linkoping Univ, Fac Hlth Sci, Dept Clin & Expt Med, Div Surg, Linkoping, Sweden
Cty Council Ostergotland, Dept Surg, Linkoping, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Myrelid, Par
Bergquist, Annika
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Karolinska Univ Hosp, Div Hepatol, Ctr Digest Dis, Stockholm, SwedenKarolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
机构:
Univ Melbourne, Melbourne Med Sch, Parkville, Vic, AustraliaUniv Melbourne, Melbourne Med Sch, Parkville, Vic, Australia
Ryan, Thomas
Segal, Jonathan P.
论文数: 0引用数: 0
h-index: 0
机构:
Royal Melbourne Hosp, City Campus, Parkville, Vic, Australia
Univ Melbourne, Dept Med, Parkville, Vic, AustraliaUniv Melbourne, Melbourne Med Sch, Parkville, Vic, Australia
机构:
Univ Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Cortez, Ramon, V
Moreira, Luana N.
论文数: 0引用数: 0
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机构:
Univ Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Moreira, Luana N.
Padilha, Marina
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机构:
Univ Sao Paulo, Sch Pharmaceut Sci, Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Padilha, Marina
Bibas, Mariana D.
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h-index: 0
机构:
Univ Sao Paulo, Dept Gastroenterol & Hepatol, Child Inst, ICR HC FM, BR-4 Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Bibas, Mariana D.
Toma, Ricardo K.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sao Paulo, Dept Gastroenterol & Hepatol, Child Inst, ICR HC FM, BR-4 Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Toma, Ricardo K.
Porta, Gilda
论文数: 0引用数: 0
h-index: 0
机构:
Hosp Municipal Infant Menino Jesus, Dept Hepatol & Liver Transplantat, Hosp Sirio Libanes, Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Porta, Gilda
Taddei, Carla R.
论文数: 0引用数: 0
h-index: 0
机构:
Univ Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
Univ Sao Paulo, Sch Arts Sci & Humanities, Sao Paulo, BrazilUniv Sao Paulo, Sch Pharm Sci, Dept Clin & Toxicol Anal, Sao Paulo, Brazil
机构:
Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of SciencesDepartment of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of Sciences
Lukas Bajer
Miloslav Kverka
论文数: 0引用数: 0
h-index: 0
机构:
Institute of Experimental Medicine, the Czech Academy of Sciences
Department of Genetics and Microbiology, Faculty of Science, Charles UniversityDepartment of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of Sciences
Miloslav Kverka
Martin Kostovcik
论文数: 0引用数: 0
h-index: 0
机构:
BIOCEV, Institute of Microbiology, the Czech Academy of SciencesDepartment of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of Sciences
Martin Kostovcik
Peter Macinga
论文数: 0引用数: 0
h-index: 0
机构:
Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of SciencesDepartment of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of Sciences
Peter Macinga
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机构:
Jiri Dvorak
论文数: 引用数:
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Zuzana Stehlikova
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Jan Brezina
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Pavel Wohl
Julius Spicak
论文数: 0引用数: 0
h-index: 0
机构:
Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of SciencesDepartment of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of Sciences
Julius Spicak
Pavel Drastich
论文数: 0引用数: 0
h-index: 0
机构:
Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of SciencesDepartment of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine
2. Institute of Microbiology, the Czech Academy of Sciences
机构:
Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Karolinska Univ Hosp, Dept Upper GI Dis, Div Hepatol, Stockholm, Sweden
C177 Halsovagen13, S-14157 Huddinge, SwedenKarolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Lundberg Bave, Aiva
Olen, Ola
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden
Karolinska Inst, SachsChildren & Youth Hosp, Dept Clin Sci & Educ Sodersjukhuset, Stockholm, SwedenKarolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Olen, Ola
Soederling, Jonas
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, SwedenKarolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Soederling, Jonas
Ludvigsson, Jonas F.
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Med Epidemiol & Biostat, Stockholm, Sweden
Orebro Univ Hosp, Dept Pediat, Stockholm, SwedenKarolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Ludvigsson, Jonas F.
Bergquist, Annika
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Karolinska Univ Hosp, Dept Upper GI Dis, Div Hepatol, Stockholm, SwedenKarolinska Inst, Dept Med Huddinge, Stockholm, Sweden
Bergquist, Annika
Nordenvall, Caroline
论文数: 0引用数: 0
h-index: 0
机构:
Karolinska Inst, Dept Mol Med & Surg, Stockholm, Sweden
Karolinska Univ Hosp, Dept Pelv Canc, Stockholm, SwedenKarolinska Inst, Dept Med Huddinge, Stockholm, Sweden