ASGE Annual GI Advanced Practice Provider Course (Virtual) - Clinical Case-Based Learning (Day Two)

Video Transcription

Video Summary

In this video, Andrea Gossard, a certified nurse practitioner and associate professor of medicine at Mayo Clinic, reviews various case studies related to liver disease. She begins with a case study of a 54-year-old woman with elevated liver tests and fatigue. Further evaluation reveals persistently elevated liver enzyme levels and a positive anti-mitochondrial antibody, leading to a diagnosis of primary biliary cholangitis (PBC). Gossard discusses the clinical presentation, management options, and prognosis for PBC patients. She then presents a case of a patient with escalating fatigue, right upper quadrant pain, and generalized aches, along with elevated liver enzymes and bilirubin levels. The additional laboratory work reveals increased immunotransferase levels and positive autoantibodies, indicating a diagnosis of autoimmune hepatitis. Gossard explains the clinical presentation, diagnostic methods, and treatment options for autoimmune hepatitis. Finally, she discusses primary sclerosing cholangitis (PSC), its association with inflammatory bowel disease, diagnostic approaches using MR cholangiography, and surveillance for complications such as cholangiocarcinoma. Gossard also mentions the challenges in finding FDA-approved therapies for PSC and the management of overlap syndromes. She concludes by emphasizing the importance of individualized therapeutic management and monitoring for disease progression in autoimmune liver diseases.

Asset Subtitle

Andrea Gossard, APRN, CNP

Keywords

liver disease

case studies

primary biliary cholangitis

autoimmune hepatitis

primary sclerosing cholangitis

individualized therapeutic management