To report a complex case of persistent intrahepatic cholestasis in a patient with adult-onset Still’s disease, highlighting the multiple contributing factors involved.
Approach:
Patient Background: A 42-year-old man with a history of adult-onset Still’s disease developed severe intrahepatic cholestasis attributed to liver injury and drug-induced liver injury, specifically related to glucocorticoid use.
Key Findings:
Persistent intrahepatic cholestasis can arise from multiple overlapping etiologies, including drug-induced liver injury and sepsis.
Sepsis may complicate the clinical picture and worsen liver function, particularly in patients receiving glucocorticoids.
Timely reassessment of etiology is crucial for effective management of complex cases.
Interpretation:
This case illustrates the complexities involved in diagnosing and managing intrahepatic cholestasis with multiple potential causes.
Limitations:
The report is based on a single case, limiting generalizability and the ability to draw broader conclusions.
Long-term outcomes and follow-up data are not provided, which may affect the understanding of the condition's progression.
Conclusion:
This case underscores the importance of continuous etiological reassessment in managing persistent intrahepatic cholestasis.
