Specialized multi-disciplinary comprehensive diagnosis and treatment of rapidly progressing hidden PSC: a rare case report

Background: Primary sclerosing cholangitis is a rare chronic disease of the hepatobiliary system, characterized by multifocal bile duct strictures and progressive liver damage. Its diagnosis and treatment are both a major challenge. To provide a new direction, we described a very rare case of PSC in a woman who had an insidious onset and a very rapid progression, with a method of specialized multi-disciplinary comprehensive diagnosis and treatment. Case presentation: A 32-year-old Chinese female presented with only hypohepatia on a physical examination. The diagnosis was not clear by biochemical tests, imaging, liver biopsy, and genetic test. The patient, however, had recurrent hypohepatia for over 2 years, so she was re-visited. Through further review of imaging, laboratory tests, endoscopy, and a discussion by the specialized multidisciplinary team, the diagnosis of primary sclerosing cholangitis was finally confirmed. And there was a significant improvement in her hypohepatia after taking ursodeoxycholic. Conclusions Physicians should be alert to the occurrence of PSC when their patients have unexplained recurrent hypohepatia dominated by elevated ALP and GGT. And maybe specialized multi-disciplinary comprehensive diagnosis and treatment could be a new method to confirm this rare disease.