University of Wisconsin–Madison Medical College of Wisconsin

A Case of COVID Cholangiopathy and Literature Review

Vishwajit Kode, MD; Joseph Puetz, MD; Abrahim N. Razzak, BS; Pinky Jha, MD

WMJ. 2023;122(5):372-376

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Introduction: With cholangiopathy, the bile ducts become inflamed and have a “beads on string appearance” with elevated bilirubin. It is typically associated with primary sclerosing cholangitis but is now being reported as a post-COVID complication.

Case Presentation: A 65-year-old White male presented with resolved respiratory failure from COVID-19 pneumonia, jaundice, and likely subacute kidney injury. He was diagnosed with COVID-19 cholangiopathy due to clinical picture and magnetic resonance cholangiopancreatography imaging. Unfortunately, due to a massive refractory gastrointestinal bleed, he was transitioned to hospice care.

Discussion: COVID-19 has been shown to have both short- and long-term effects on multiple organ systems. Cholangiopathy is a rare complication of COVID-19. Most of these cases result in severe liver failure and require liver transplant, similar to primary sclerosing cholangitis.

Conclusions: We report this case to increase awareness among clinicians to consider COVID-19 cholangiopathy in patients with unexplained jaundice and a history of severe COVID-19 infection.

Author Affiliations: Medical College of Wisconsin, Milwaukee, Wisconsin (Kode, Puetz, Razzak, Jha).
Corresponding Author: Abrahim N. Razzak, 8701 W Watertown Plank Rd, Wauwatosa, WI 53226; email; ORCID ID 0000-0001-6564-1165
Funding/Support: None declared.
Financial Disclosures: None declared.
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