A patient with a history of autoimmune deficiency syndrome presents with jaundice and marked elevation in bilirubin and alkaline phosphatase. The sonographic findings are most consistent with:

A patient with a history of autoimmune deficiency syndrome presents with jaundice and marked elevation in bilirubin and alkaline phosphatase. The sonographic findings are most consistent with:

• A. Ascariasis
• B. Cholangitis
• C. Clonorchiasis
• D. Cholangiocarcinoma

Answer: (B)

The findings described in the scenario, particularly the history of autoimmune deficiency syndrome along with jaundice and a marked elevation in bilirubin and alkaline phosphatase, align well with cholangitis. This condition often arises due to an obstruction in the bile ducts, leading to inflammation and infection of the biliary system. In patients with compromised immune systems, such as those with autoimmune deficiency syndrome, the risk of infections and biliary complications increases. The elevated alkaline phosphatase suggests a cholestatic process, and jaundice is indicative of elevated bilirubin levels due to an inability to excrete bile effectively, which can occur with cholangitis. Sonographically, cholangitis may present with dilated bile ducts and potential evidence of liver abscesses or thickening of the bile duct walls, which would be consistent with inflammation. Therefore, the combination of these clinical features and ultrasound findings strongly supports a diagnosis of cholangitis in this patient.

The findings described in the scenario, particularly the history of autoimmune deficiency syndrome along with jaundice and a marked elevation in bilirubin and alkaline phosphatase, align well with cholangitis. This condition often arises due to an obstruction in the bile ducts, leading to inflammation and infection of the biliary system.

In patients with compromised immune systems, such as those with autoimmune deficiency syndrome, the risk of infections and biliary complications increases. The elevated alkaline phosphatase suggests a cholestatic process, and jaundice is indicative of elevated bilirubin levels due to an inability to excrete bile effectively, which can occur with cholangitis.

Sonographically, cholangitis may present with dilated bile ducts and potential evidence of liver abscesses or thickening of the bile duct walls, which would be consistent with inflammation. Therefore, the combination of these clinical features and ultrasound findings strongly supports a diagnosis of cholangitis in this patient.