PDF(Pubmed)
Abstract：
Two major etiologies of hyperbilirubinemia include hemolysis and cholestasis. Although rare, the former can give rise to the latter through the formation of pigment gallstones and subsequent biliary tree obstruction. We report a case of a 57-year-old woman with systemic lupus erythematosus who presented with dyspnea and right upper quadrant abdominal pain. She was found to have hepatolithiasis and choledocholithiasis secondary to warm autoimmune hemolytic anemia in the setting of COVID-19. In patients with symptomatic anemia secondary to acute hemolysis and concomitant right upper quadrant abdominal pain, elevated hepatocellular laboratory results should prompt a high clinical suspicion for biliary tree pigment stones.
摘要：
高胆红素血症的两种主要病因包括溶血和胆汁淤积。虽然罕见，前者可以通过色素胆结石的形成和随后的胆道树阻塞引起后者。我们报告了一例57岁的女性，患有系统性红斑狼疮，表现为呼吸困难和右上腹腹痛。在COVID-19的情况下，她被发现患有继发于热自身免疫性溶血性贫血的肝胆管结石和胆总管结石。在有症状的贫血继发于急性溶血和伴随右上腹腹痛的患者中，升高的肝细胞实验室结果应提示临床高度怀疑胆道树色素结石。
