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!
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, 20 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.