Published online Dec 26, 2020. doi: 10.12998/wjcc.v8.i24.6524
Peer-review started: September 25, 2020
First decision: October 18, 2020
Revised: October 26, 2020
Accepted: November 2, 2020
Article in press: November 2, 2020
Published online: December 26, 2020
Processing time: 85 Days and 8.1 Hours
Idiopathic adulthood ductopenia (IAD) is a chronic cholestatic liver disease of unknown etiology that usually presents as unexplained jaundice. It is characterized by adult onset, lack of autoantibodies, inflammatory bowel disease and loss of interlobular bile ducts.
This case presents a 27-year-old woman with elevation of transaminases and alkaline phosphatase without clinical symptoms. Five years ago, the patient had abnormal transaminases but no cholestasis. Three months before admission, physical examination revealed an increase in transaminases. Oral hepatoprotective drugs did not show any significant improvement, and she was admitted to hospital for further diagnosis and treatment. Liver biopsy confirmed IAD. After about 2 wk of ursodeoxycholic acid treatment, serological and histological examination showed a significant response.
IAD is a manifestation of cholestasis, but also may be an abnormal increase in transaminase in the early stage.
Core Tip: Idiopathic adulthood ductopenia (IAD) is a chronic cholestatic liver disease that has unclear etiology, usually manifested as cholestasis. We report a case with no cholestasis or obvious clinical symptoms, only an increase in transaminases. The diagnosis of IAD relies on liver tissue biopsy. However, this examination is invasive and thus not acceptable by all patients. Therefore, in the clinical diagnostic process, many cases of unexplained liver damage and jaundice are missed. Furthermore, this case proved that the application of ursodeoxycholic acid has an obvious positive effect in the treatment of IAD.