AIDS cholangiopathy

Case contributed by Dr Pavan Borra

Presentation

Known HIV+ve patient with right hypochondriac pain and fever.

Patient Data

Age: 45 years
Gender: Male

Intra and extra hepatic biliary dilatation noted with multiple small outpouchings  from peripheral intrahepatic biliary radicals, seen as small hyperintensities with surrounding edema on T2 fat sat in right lobe of liver.

Beaded appearance of intrahepatic biliary radicals noted similar to sclerosis cholangitis.

T2 hypointense calculous noted in distal end of CBD.

 Multiple small hypodensities noted in liver adjacent dilated peripheral intrahepatic biliary radicals. Distal CBD calculous with biliary dilatation is seen.

Case Discussion

Diagnosis of AIDS cholangiopathy was made as the patient was HIV+ve with very low CD4 counts <100 cells/mm3.

Infectious cholangitis characterized by opportunistic organisms in AIDS patients is known as AIDS cholangiopathy. The differential diagnosis includes sclerosing cholangitis and pyogenic cholangitis.

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