Case Report: Sclerosing Cholangitis, Inflammatory Bowel Disease, and Glomerulonephritis (A Case Report of a Rare Triad)

A 30-year-old white male presented with ascites, lower extremity edema, and diarrhea of several months duration. Physical examination was notable for stigmata of chronic liver disease. His past medical history was signi® cant for a splenectomy and a wedge liver biopsy at age 14 for a presumptive diagnosis of schistosomiasis acquired while living in Africa several years prior. The liver biopsy at that time, however, did not show evidence of schistosomiasis. In fact, on review, the biopsy had evidence of portal ® brosis and bile duct proliferation. The patient was well following his splenectomy until the development of his recent symptoms. He had a history of rare alcohol use, no blood transfusions, viral hepatitis, exposure to hepatotoxins, or episodes of jaundice. Laboratory evaluation revealed the