Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study
The etiology of primary sclerosing cholangitis (PSC) is unknown. I present a case which may be indicative of a causal link between <i>Bartonella</i> infection and PSC. The patient presented with complaints of abdominal pain and bloody diarrhea. A colonoscopy demonstrated chronic inflamma...
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| Format: | Article |
| Language: | English |
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MDPI AG
2020-03-01
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| Series: | Gastrointestinal Disorders |
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| Online Access: | https://www.mdpi.com/2624-5647/2/1/5 |
| _version_ | 1818269857830928384 |
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| author | Daniel A. Kinderlehrer |
| author_facet | Daniel A. Kinderlehrer |
| author_sort | Daniel A. Kinderlehrer |
| collection | DOAJ |
| description | The etiology of primary sclerosing cholangitis (PSC) is unknown. I present a case which may be indicative of a causal link between <i>Bartonella</i> infection and PSC. The patient presented with complaints of abdominal pain and bloody diarrhea. A colonoscopy demonstrated chronic inflammation and changes consistent with ulcerative colitis. Routine laboratory studies revealed elevated liver function tests (LFTs); ultrasound and magnetic resonance imaging (MRI) confirmed the diagnosis of PSC. <i>Bartonella</i> serology was positive. It is established that <i>Bartonella</i> infection is associated with both gastrointestinal inflammation and autoimmunity; indeed, there is an animal model for <i>Bartonella</i>-induced PSC. <i>Bartonella</i> is susceptible to treatment with vancomycin and there are case reports and small series that demonstrate that PSC responds to treatment with oral vancomycin. Because of this, it is postulated that at least some cases of PSC may be associated with <i>Bartonella</i> infection. The patient in this report was treated with oral vancomycin and, since then, has been in remission for both colitis and PSC. Since vancomycin is not systemically absorbed, the premise is that he suffered from <i>Bartonella</i> colitis and an autoimmune reaction to <i>Bartonella</i> causing PSC. This premise warrants further study. |
| first_indexed | 2024-12-12T21:01:03Z |
| format | Article |
| id | doaj.art-54d78d9624d14ecbaba05ca26c99983e |
| institution | Directory Open Access Journal |
| issn | 2624-5647 |
| language | English |
| last_indexed | 2024-12-12T21:01:03Z |
| publishDate | 2020-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastrointestinal Disorders |
| spelling | doaj.art-54d78d9624d14ecbaba05ca26c99983e2022-12-22T00:12:08ZengMDPI AGGastrointestinal Disorders2624-56472020-03-0121485710.3390/gidisord2010005gidisord2010005Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case StudyDaniel A. Kinderlehrer0668 South Newport Street, Denver, CO 80224, USAThe etiology of primary sclerosing cholangitis (PSC) is unknown. I present a case which may be indicative of a causal link between <i>Bartonella</i> infection and PSC. The patient presented with complaints of abdominal pain and bloody diarrhea. A colonoscopy demonstrated chronic inflammation and changes consistent with ulcerative colitis. Routine laboratory studies revealed elevated liver function tests (LFTs); ultrasound and magnetic resonance imaging (MRI) confirmed the diagnosis of PSC. <i>Bartonella</i> serology was positive. It is established that <i>Bartonella</i> infection is associated with both gastrointestinal inflammation and autoimmunity; indeed, there is an animal model for <i>Bartonella</i>-induced PSC. <i>Bartonella</i> is susceptible to treatment with vancomycin and there are case reports and small series that demonstrate that PSC responds to treatment with oral vancomycin. Because of this, it is postulated that at least some cases of PSC may be associated with <i>Bartonella</i> infection. The patient in this report was treated with oral vancomycin and, since then, has been in remission for both colitis and PSC. Since vancomycin is not systemically absorbed, the premise is that he suffered from <i>Bartonella</i> colitis and an autoimmune reaction to <i>Bartonella</i> causing PSC. This premise warrants further study.https://www.mdpi.com/2624-5647/2/1/5bartonellaprimary sclerosing cholangitisautoimmunecolitis |
| spellingShingle | Daniel A. Kinderlehrer Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study Gastrointestinal Disorders bartonella primary sclerosing cholangitis autoimmune colitis |
| title | Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study |
| title_full | Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study |
| title_fullStr | Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study |
| title_full_unstemmed | Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study |
| title_short | Is <i>Bartonella</i> a Cause of Primary Sclerosing Cholangitis? A Case Study |
| title_sort | is i bartonella i a cause of primary sclerosing cholangitis a case study |
| topic | bartonella primary sclerosing cholangitis autoimmune colitis |
| url | https://www.mdpi.com/2624-5647/2/1/5 |
| work_keys_str_mv | AT danielakinderlehrer isibartonellaiacauseofprimarysclerosingcholangitisacasestudy |