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We report a unique case of a 10-year-old Danish boy with severe small duct autoimmune sclerosing cholangitis and synchronic Crohn colitis. He was referred with a history of weight loss, abdominal pain, vomiting and diarrhea. Biochemical anomalies included elevated alanine aminotransferase, \u03b3-glutamyl transferase and immunoglobulin G levels and the presence of smooth muscle antibodies and perinuclear antineutrophil cytoplasmic antibodies but normal alkaline phosphatase. Liver biopsy specimen revealed features of both autoimmune hepatitis and sclerosing cholangitis, the latter characterized by acute, hyperplastic and destructive inflammation \u2013 granulocytic epithelial lesion \u2013 of the small ducts. Magnetic resonance cholangiography was normal. Colonoscopic biopsies showed chronic inflammatory changes of the caecum and the ascending and transverse colon compatible with Crohn disease. Ursodeoxycholic acid and immunosuppressive treatment was initiated and within four weeks of treatment the general condition improved. Normalization of aminotransferase was seen at 21\u2009weeks and \u03b3-glutamyl transferase at 72\u2009weeks after first admittance, while immunoglobulin G remained slightly increased.<\/jats:p><\/jats:sec><jats:sec><jats:title>Virtual slides<\/jats:title><jats:p>The virtual slide(s) for this article can be found here:<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/www.diagnosticpathology.diagnomx.eu\/vs\/1418596609736470\" ext-link-type=\"uri\">http:\/\/www.diagnosticpathology.diagnomx.eu\/vs\/1418596609736470<\/jats:ext-link><\/jats:p><\/jats:sec>","DOI":"10.1186\/1746-1596-7-100","type":"journal-article","created":{"date-parts":[[2012,8,14]],"date-time":"2012-08-14T10:14:54Z","timestamp":1344939294000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Small duct autoimmune sclerosing cholangitis and Crohn colitis in a 10-year-old child. 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