Pediatr. praxi. 2025;26(4):242-245 | DOI: 10.36290/ped.2025.047

"Leg-Gut-and-Liver disease": leg pain as an unusual indicator of ulcerative colitis and primary sclerosing cholangitis

MUDr. David Klepárník1, MUDr. Mária Véghová-Velgáňová1, MUDr. Lenka Rašková2, doc. MUDr. Jana Volejníková, Ph.D.1
1 Dětská klinika, Lékařská fakulta Univerzity Palackého a Fakultní nemocnice Olomouc
2 Dětské oddělení Nemocnice Agel Jeseník, a. s.

A 13-year-old previously healthy male was admitted for pressure and cramping pain of the lower limbs, unresponsive to common analgesics. The episode of pain followed a respiratory infection with cough and fever; there were no other concurrent symptoms. Laboratory tests showed no evidence of myositis but, surprisingly, a significant elevation of gamma-glutamyltransferase (GGT), alkaline phosphatase (ALP), only mild elevations in transaminases, conjugated bilirubin and lactate dehydrogenase (LDH). After excluding hepatotropic infections, he was transferred to a tertiary care hospital, where he was diagnosed with ulcerative colitis (UC) and primary sclerosing cholangitis (PSC). 

A peculiar incidental finding during the initial diagnostic work-up was a radiopaque tablet of potassium chloride in the digestive tract, mimicking a foreign object.

The aim of this case report is to emphasize unusual and often subtle manifestation of a severe liver disease.

Keywords: hepatopathy, inflammatory bowel disease (IBD), leg pain, primary sclerosing cholangitis (PSC), ulcerative colitis (UC).

Accepted: August 20, 2025; Published: September 26, 2025  Show citation

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Klepárník D, Véghová-Velgáňová M, Rašková L, Volejníková J. "Leg-Gut-and-Liver disease": leg pain as an unusual indicator of ulcerative colitis and primary sclerosing cholangitis. Pediatr. praxi. 2025;26(4):242-245. doi: 10.36290/ped.2025.047.
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