intrahepatic%20cholestasis
INTRAHEPATIC CHOLESTASIS
Cholestasis is bile formation and/or bile flow impairment that manifests as fatigue, pruritus and jaundice.
It can be classified into intrahepatic or extrahepatic cholestasis.
Extrahepatic cholestasis develops from mechanical blockage in the duct system or hepatocellular defects.
Intrahepatic cholestasis may be due to functional defects hepatocellularly or from obstructive lesions of the intrahepatic biliary tract distal from the bile canaliculi.

Follow Up

  • In patients with PSC, suspect cholangiocarcinoma if with weight loss, worsening cholestasis, elevated serum level of CA 19-9, and/or new or progressive stricture, especially with an enhancing mass lesion 
  • Follow-up in ICP patients should be long enough to ensure a normalization of LFTs, and it is reasonable to check LFTs at 6 weeks
    • If after 6 months there is no improvement, further specialist input will be required 
  • ICP should settle spontaneously following delivery
  • The outcome of drug-induced cholestasis after withdrawal of the drug is generally good and few patients who develop DILI show abnormal liver tests and persistent histological evidence of liver damage at follow-up
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Hepatology - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Tristan Manalac, 5 days ago
The causes, presentations and management of anaphylaxis vary considerably with age, according to a recent Singapore study, which reported that children are more likely to present with food anaphylaxis, while drug anaphylaxis is more common in adults.
Pearl Toh, 4 days ago
Low-density lipoprotein cholesterol (LDL-C) levels remained high in many patients with stable or acute coronary heart disease (CHD) in Asia, despite having a very high risk of recurrent cardiovascular (CV) events, indicating that the use of lipid-lowering therapies and lipid monitoring were inadequate.
3 days ago
There is a strong association between smoking duration and colorectal polyps, independent of smoking intensity, cessation and other potential confounders, reports a recent study. Such association is more robust with distal rather than proximal polyps, and with serrated polyps rather than adenomas.
Pearl Toh, 21 hours ago

Dr Paul Chiam, a senior consultant cardiologist at The Heart & Vascular Centre, Mount Elizabeth Hospital, Singapore, shares his insights with Pearl Toh on diagnosing and managing hypertension in the primary care setting.