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.

Introduction

  • Any condition that causes bile formation and/or bile flow impairment that may lead to:
    • Retention of conjugated bilirubin and its regurgitation into serum
    • Increased serum concentration of unconjugated bilirubin
    • Increased bile salts

Etiology

Extrahepatic Cholestasis

  • Cholestasis that develops from mechanical blockage in the duct system or hepatocellular defects
  • It may be caused by stones, tumors, cysts, or strictures
  • This class will not be discussed here

Intrahepatic Cholestasis (IHC)

  • Hepatocellular functional defects or presence of obstructive lesions in the intrahepatic biliary tract distal from bile canaliculi resulting to cholestasis
  • Chronic (lasts >6 months) cholestatic diseases are commonly intrahepatic

Signs and Symptoms

  • Fatigue
  • Pruritus
  • Jaundice
Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Hepatology - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
16 hours ago
There appears to be a high rate of emergency department (ED) admission for acute exacerbation of chronic obstructive pulmonary disease (AECOPD), with patients having significant in-hospital mortality, according to data from the *AANZDEM study. Furthermore, compliance with evidence-based treatments in the ED is suboptimal.
Tristan Manalac, 4 days ago
Of the newly identified genetic loci for primary angle-closure glaucoma (PACG), two are significantly associated with primary angle-closure suspect (PACS), indicating involvement in the earlier stages of the disease, a recent Singapore study has shown.
Pearl Toh, Yesterday
Patients with inflammatory bowel disease (IBD) who had primary nonresponse to an anti-tumour necrosis factor (TNF) agent ─ or inadequate response to the initial loading doses ─ were less likely to respond to second-line biologics compared with those who had secondary loss of response (LOR) or intolerance to the primary therapy, according to a systematic review and meta-analysis presented at the Crohn's & Colitis Congress (CCC) 2018 held recently in Las Vegas, Nevada, US.
Tristan Manalac, 6 days ago
Placebo pills, even when administered open-label, appear to significantly improve cancer-related fatigue and fatigue-disrupted quality of life, according to a recent study.