Auto-immune disease and ulcerative colitis primary sclerosing Cholangitis

Fifty years old lady was diagnosed as ulcerative colitis in 2000 by colonoscopy biopsy. She received Pentasa and Ursofalk for nearly one year. Then she had lab results showing rise in the level of liver enzymes up to seven folds. MRI(MRCP) and CT on portahepatis were done and was diagnosed as primary sclerosing colangitis for which she had ERCP to adhesions.

• Liver enzymes returned back to normal and Thank God she was doing more or less well for 15 years receiving Pentasa 2x2 and Ursofaalk 2x2 regularly.
• Eight months ago she observed an increase again in the liver enzymes (SGOT, SGIPT, γGT and alkaline phosphatase but biliruben level remained normal till 19.5.2015.
• Lab results showed on 23.8.2015 showed a rise in the direct biliruben up to 0.9 (N=0.2) in addition to the rest of the enzymes.
• Platelets showed gradual decrease (after severe prolonged psychological troubles with her family); now it counts 50,000 raised slightly on 10 ml solupred daily