Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant

Progressive familial intrahepatic cholestasis (PFIC) is a group of rare autosomal recessive cholestatic liver diseases that typically manifest in infancy or childhood. It is characterized by intrahepatic cholestasis, jaundice, pruritus, and malabsorption, with potential progression to cirrhosis, liv...

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Main Authors: Zhang Huimin, Wang Yuan, Xu Chuanyan, Chen Jing
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Gastroenterology
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Online Access:https://www.frontiersin.org/articles/10.3389/fgstr.2025.1435168/full
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author Zhang Huimin
Wang Yuan
Xu Chuanyan
Chen Jing
author_facet Zhang Huimin
Wang Yuan
Xu Chuanyan
Chen Jing
author_sort Zhang Huimin
collection DOAJ
description Progressive familial intrahepatic cholestasis (PFIC) is a group of rare autosomal recessive cholestatic liver diseases that typically manifest in infancy or childhood. It is characterized by intrahepatic cholestasis, jaundice, pruritus, and malabsorption, with potential progression to cirrhosis, liver failure, and hepatocellular carcinoma. Here, we report a 36-year-old Chinese male patient with delayed-onset PFIC who presented with recurrent jaundice and pruritus. Laboratory investigations excluded viral, autoimmune, or neoplastic causes of liver injury. Liver biopsy demonstrated hepatocyte hydropic degeneration and intracanalicular bile thrombi, while genetic testing revealed compound heterozygous variants in the MYO5B gene: c.3604-1G>C and c.1165G>T (p.V389F). The patient exhibited fluctuating bilirubin levels refractory to initial therapies including corticosteroids, ursodeoxycholic acid, cholestyramine, and artificial liver support. However, bilirubin normalization was achieved following adjunctive traditional Chinese medicine therapy after transfer to our institution. This case highlights that genetic etiologies, particularly MYO5B-related disorders, should be considered in patients presenting with recurrent hyperbilirubinemia, pruritus, and hepatosplenomegaly after excluding common causes (viral, autoimmune, drug-induced, or tumor-related). Genetic testing for MYO5B mutations is warranted in cases of high bilirubin with normal/mildly elevated GGT levels, as early recognition is critical for timely intervention.
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spelling doaj-art-e901ee43aee74b6ebaf6743bf2f83bb62025-08-20T03:07:27ZengFrontiers Media S.A.Frontiers in Gastroenterology2813-11692025-06-01410.3389/fgstr.2025.14351681435168Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variantZhang HuiminWang YuanXu ChuanyanChen JingProgressive familial intrahepatic cholestasis (PFIC) is a group of rare autosomal recessive cholestatic liver diseases that typically manifest in infancy or childhood. It is characterized by intrahepatic cholestasis, jaundice, pruritus, and malabsorption, with potential progression to cirrhosis, liver failure, and hepatocellular carcinoma. Here, we report a 36-year-old Chinese male patient with delayed-onset PFIC who presented with recurrent jaundice and pruritus. Laboratory investigations excluded viral, autoimmune, or neoplastic causes of liver injury. Liver biopsy demonstrated hepatocyte hydropic degeneration and intracanalicular bile thrombi, while genetic testing revealed compound heterozygous variants in the MYO5B gene: c.3604-1G>C and c.1165G>T (p.V389F). The patient exhibited fluctuating bilirubin levels refractory to initial therapies including corticosteroids, ursodeoxycholic acid, cholestyramine, and artificial liver support. However, bilirubin normalization was achieved following adjunctive traditional Chinese medicine therapy after transfer to our institution. This case highlights that genetic etiologies, particularly MYO5B-related disorders, should be considered in patients presenting with recurrent hyperbilirubinemia, pruritus, and hepatosplenomegaly after excluding common causes (viral, autoimmune, drug-induced, or tumor-related). Genetic testing for MYO5B mutations is warranted in cases of high bilirubin with normal/mildly elevated GGT levels, as early recognition is critical for timely intervention.https://www.frontiersin.org/articles/10.3389/fgstr.2025.1435168/fullcholestasisnovel mutationMYO5BPFICBSEP
spellingShingle Zhang Huimin
Wang Yuan
Xu Chuanyan
Chen Jing
Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant
Frontiers in Gastroenterology
cholestasis
novel mutation
MYO5B
PFIC
BSEP
title Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant
title_full Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant
title_fullStr Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant
title_full_unstemmed Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant
title_short Case Report: A rare case of familial progressive cholestasis type 10 in an adult with heterozygous MYO5B variant
title_sort case report a rare case of familial progressive cholestasis type 10 in an adult with heterozygous myo5b variant
topic cholestasis
novel mutation
MYO5B
PFIC
BSEP
url https://www.frontiersin.org/articles/10.3389/fgstr.2025.1435168/full
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