Tekeste Rahel, Villarreal Elvia, Moy Matthan, Karnath Bernard
Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, USA.
Cureus. 2023 Sep 15;15(9):e45311. doi: 10.7759/cureus.45311. eCollection 2023 Sep.
Primary sclerosing cholangitis (PSC) is a rare type of autoimmune hepatic disease with unknown pathophysiology, often a sequela of ulcerative colitis (UC). Liver transplant, though curative, is inaccessible to many patients due to stringent organ availability and barriers to sufficient insurance coverage. Low health literacy and low socioeconomic class can significantly limit healthcare access and thus worsen overall healthcare outcomes. Here, we present the case of an uninsured 49-year-old man with untreated UC who was diagnosed with PSC and subsequently became lost to follow-up. It is critical for providers to identify barriers to acquiring appropriate medical care, such as financial instability and low health literacy, when identifying and treating conditions like PSC. Moreover, more research should be performed to investigate alternative treatments for PSC.
原发性硬化性胆管炎（PSC）是一种罕见的自身免疫性肝病，其病理生理学尚不清楚，通常是溃疡性结肠炎（UC）的后遗症。肝移植虽然可以治愈，但由于器官供应严格以及足够保险覆盖的障碍，许多患者无法获得。健康素养低和社会经济阶层低会严重限制医疗保健的可及性，从而恶化整体医疗保健结果。在此，我们介绍一例49岁未参保男性的病例，该患者患有未经治疗的UC，被诊断为PSC，随后失访。在识别和治疗PSC等疾病时，医疗服务提供者识别获得适当医疗护理的障碍（如经济不稳定和健康素养低）至关重要。此外，应该进行更多研究以调查PSC的替代治疗方法。
