To Whom It May Concern:

I care for Ryan Thompson, who is a 17-year-old male with inflammatory bowel disease and primary sclerosing cholangitis. Ryan came under my care in the spring of 2005. At that time, he presented with shortness of breath, jaundice, and diarrhea. He was subsequently diagnosed with pulmonary nodules secondary to inflammatory bowel disease, IBD, and ultimately diagnosed with sclerosing cholangitis. These are conditions that have no cure and have lifelong impact on health-related quality of life.

As a result, Ryan has had multiple physician contacts and multiple hospitalizations. He was hospitalized in April 2007. He was hospitalized again in September 2007. During this hospitalization, he underwent a thoracoscopic biopsy of his lungs. He has had endoscopic procedures on April 11, 2005; December 5, 2006; and September 6, 2007. He has had CT scans of his chest on April 25, 2005; January 23, 2007; February 6, 2007; March 5, 2007; and August 1, 2007, as well as September 11, 2007. He has had a liver biopsy on April 8, 2005. He had an MRI of his abdomen on October 23, 2006. He also had an endoscopic retrograde cholangiopancreatography at the University of Utah on October 30, 2006. He has had two doses of infliximab given intervenously. He has had chest x-rays April 7, 2005; June 9, 2005; December 6, 2005; December 5, 2006; January 22, 2007; May 10, 2007; and September 13, 2007.

Thanks very much for your attention.

Sincerely,

 

Stephen L. Guthery, MDm MSc