The incidence of primary sclerosing cholangitis and inflammatory bowel disease in early chilhood is very rare. There is a description of the case of five years old girl who had suffered from bloody diarrhea and rectal urgency. After treatment with mesalazine she transitory improved, but after one year later severe activity of ulcerative colitis developed again. She has become unresponsive to classical therapy with mesalazine and corticosteroids. The combine immunosuppressive therapy was started, including high dose of corticosteroids and cyclosporine A. Despite of intensive drug therapy moderate activity of ulcerative colitis was continued for three years period. The elevation of cholestatic functional liver tests and positive serology against CMV infection were proved repeatedly. In differential diagnosis we have to consider chronic CMV infection due to combine immunosuppressive therapy with injury of intrahepatic bile ducts. Clinical course of illness supports these idea, because after discontinuation of immunossuppresive therapy a normalization of liver function tests and remission of ulcerative colitis were demonstrated.

        Key words: inflammatory bowel disease, ulcerative colitis, sklerosing cholangitis, immunosuppressive therapy