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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.

Intrahepatic%20cholestasis Signs and Symptoms

Signs and Symptoms

Introduction

Cholestasis is 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 will not be discussed here

Intrahepatic Cholestasis

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

Clinical presentation includes fatigue, pruritus and jaundice

Reducing risks and improving long-term outcomes in patients with CHB

Prof. Vincent Wong, Prof. Ray Kim, Dr. Tan Poh Seng, 10 Sep 2019

Chronic hepatitis B (CHB) remains a major public health concern because of its worldwide distribution and potential adverse sequelae, including cirrhosis and hepatocellular carcinoma (HCC). At a recent symposium held during the GIHep Singapore 2019, Professor Vincent Wong from the Chinese University of Hong Kong and Professor Ray Kim from the Stanford University School of Medicine, Stanford, California, US, discussed antiviral treatments for CHB, with a focus on the novel agent tenofovir alafenamide (Vemlidy®). Dr Tan Poh Seng from the National University Hospital, Singapore, chaired the symposium.

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