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At least 19 recordsLinked to original sources
PubMed1990

A multivariate analysis of factors predictive of parenteral nutrition-related cholestasis (TPN cholestasis) in VLBW infants.

To identify the factors predictive of development of TPN-related cholestasis, we conducted a historical cohort analysis of 62 VLBW infants who received TPN of which 17 developed cholestasis (27.4%). In the cholestatic group, the mean duration of TPN administration was significantly longer (25.7 days vs 8 days, p less than 0.001), the maximum daily amino-acids and lipids in the TPN infusate was significantly higher (amino-acids 2.25 vs 1.25 gm/kg/day, p less than 0.001; lipids 2.0 gm/kg/day vs 1.25 gm/kg/day, p less than 0.01), the duration of fasting was significantly longer (20.7 days vs 6.3 days, p less than 0.001) and the incidence of necrotizing enterocolitis was significantly higher (58.8% vs 15.5%, p 0.02). Using a linear discriminant analysis model with development of cholestasis as the dependent variable, the duration of TPN (p 0.0000) and the maximum daily amino-acid in infusate (p 0.0000) were found to be independent variables predictive of development of cholestasis. This model may serve to identify VLBW infants who will develop cholestasis during TPN.

Amino Acids↗
PubMed1986

Extrahepatic cholestasis in the dog and the differentiation of extrahepatic and intrahepatic cholestasis.

The clinical and pathological features of extrahepatic cholestasis in 19 dogs are presented. The condition was most often caused by partial or complete occlusion of the choledochal duct due to neoplastic diseases (12 cases), inflammatory processes (3 cases), or eventration and incarceration of the liver (1 case). In only three cases was the condition due to intraluminal obstruction of the choledochal duct. The anamnestic, laboratory and pathological parameters of these 19 dogs were compared with the findings in 21 dogs with intrahepatic cholestasis. Statistical analysis of these parameters indicated that the presence of acholic faeces, the degree of icterus and the level of plasma gamma GT where the only parameters of value in the clinical differentiation of extrahepatic from intrahepatic cholestasis. Histological examination of liver biopsies is a simple aid to a confident in vivo diagnosis of extrahepatic cholestasis.

Animals↗
PubMed1979

Studies on drug-induced allergic intrahepatic cholestasis--hepatic cholestasis induced in dogs by lymphocyte culture supernatant.

When peripheral lymphocytes from patients with drug-induced allergic intrahepatic cholestasis were stimulated with a specific drug in vitro in the presence of a liver microsome fraction or soluble liver specific antigen fraction, lympholine production was seen in many cases. By the injection of culture supernatant of stimulated lymphocytes into the mesentery vein of dogs, cholestasis was induced in the liver, chiefly in the central zones of lobules. However, no cholestasis could be observed in dogs administered the supernatants of lymphocyte cultures prepared from normal individuals in the presence of drugs. Moreover, only slight swelling of the hepatocytes was observed in the liver when normal lymphocytes were stimulated with PHA-P and culture supernatant was injected into the mesentery vein of dogs. These results suggest that sensitized lymphocytes may produce a factor (or factors) by stimulation with a specific drug-carrier and this factor (or factors) causes cholestasis in the liver.

Adult↗
PubMed1976

Familial benign recurrent intrahepatic cholestasis. Interrelation with intrahepatic cholestasis of pregnancy and from oral contraceptives?

A family study was prompted by the presence of benign recurrent intrahepatic cholestasis in three members and probably in a fourth. Pruritus and/or jaundice occurred during pregnancy in nine members. Two additional members suffered from pruritus while using oral contraceptives. The literature on benign recurrent intrahepatic cholestasis since 1959 describes at least 57 cases. A familial form of this condition proved to be fairly common. There seems to be a relation to the intrahepatic cholestasis sometimes seen during pregnancy and during oral contraceptive use. The data of the family study are suggestive for an interrelation of the three types of intrahepatic cholestasis, although a common denominator remains obscure.

Adult↗
PubMed1975

[Ultrastructural-morphometric analysis of liver biopsies in patients with intrahepatic cholestasis. I. Correlations between morphometry of bile canaliculi and so-called "marker enzymes of cholestasis" (author's transl)].

Reports on correlations between the activity of so-called "marker enzymes of cholestasis" in serum and the ultrastructural changes of the liver are rare. Therefore studies of ultrastructural changes were carried out in 40 patients with intrahepatic cholestasis. In the patients' serum activity of alkaline phosphatase, bile duct alkaline phosphatase, leucine-aminopeptidase (LAP), and 5'-nucleotidase (5'-Nu) as well as the concentration of bilirubin were determined. The results showed a significant correlation between the morphometry of the bile canaliculi and the serum activity of LAP and 5'-Nu. In patients with elevated LAP, an enlargement of the bile canaliculi could be proved. An increased serum activity of 5'-Nu correlated with a higher incidence of bile canaliculi in the ultrastructural picture. The results suggest an investigation of the ultrastructure of bile canaliculi and the determination of marker enzymes of cholestasis in the serum may both contribute to the assessment of cholestatic liver disease.

Alkaline Phosphatase↗
PubMed1991

[Cholestasis and prostatic carcinoma. Description of a case and review of paraneoplastic cholestasis].

We report a patient with cholestasis associated with prostatic carcinoma. When metastasic hepatic occupation, bile tract obstruction and other causes were ruled out, cholestasis was attributed to carcinoma itself as a paraneoplastic syndrome. This possibility has been previously reported as exceptional in prostatic carcinoma and in other tumors. We review cholestasis associated with tumors and we discuss its possible etiological and pathogenetical mechanisms.

Adenocarcinoma↗
PubMed1978

A father and son with cholestasis and peripheral pulmonic stenosis: a distinct form of intrahepatic cholestasis.

We report a father and son with the syndrome of cholestasis and peripheral pulmonic stenosis. These cases demonstrate the clinical and biochemical features noted in previous reports of this entity and allows us to differentiate clearly this syndrome, with its benign course, from other more progressive forms of intrahepatic cholestasis. The vertical transmission supports a genetic etiology for this disease. Although serum bile acid levels are elevated in these patients, the individual bile acids do not display a distinctive pattern and no abnormal bile acids are identified.

Adult↗
PubMed1978

Study of the activity of antithrombin-III in latent cholestasis. (A clinico-pharmacological study of the relationship between antithrombin-III activity and steroid cholestasis).

The relationship between steroid cholestasis and antithrombin-III activity were examined in users of oral contraceptives (Infecundin or Bisecurin) and in patients receiving anabolic hormone therapy (Nerobol). The control group for the oral contraceptive users consisted of patients with spontaneous anovulation. The untreated control group consisted of healthy women in the reproductive age. The increase in antithrombin-III activity was found to be directly related to the decline of anion excretion. Latent cholestasis in itself is not associated with an increased antithrombin-III activity, nor is the activity of antithrombin-III affected by long-continued use of those anabolic steroids which produce no decrease in anion excretion.

Adult↗
PubMed1989

Benign recurrent intrahepatic cholestasis: a long-term follow-up study of two patients.

Two brothers with benign recurrent intrahepatic cholestasis were studied over a period of 6 years. During this period, 11 episodes of cholestasis were observed, with a mean duration of 2.6 months (range: 2 weeks to 6 months). Once, both brothers developed cholestasis simultaneously. There was a prevalence for episodes of cholestasis in wintertime. The postprandial rise in serum sulfated glycolithocholic acid was increased in the patients, and the bile acid pool was enriched with secondary bile acids. In periods prior to cholestasis, the urinary 3 alpha OH-bile acid concentration was often elevated (greater than 50 mumoles per liter) without a clear correlation with the clinical prodromata. However, it could not be used as a predictor of cholestasis. In contrast, the postprandial rise in serum 3 alpha OH-bile acids was always grossly elevated in periods just before cholestasis. An increase both in fecal bile acid excretion as well as secondary bile acids in the bile acid pool indicated an increased spillover of bile acids into the large bowel. Cholestyramine administered directly after the first signs of cholestasis appeared to shorten an episode of cholestasis. On the other hand, withdrawal of cholestyramine in a cholestasis-free period may have resulted in an episode of cholestasis. Neither taurine supplementation for 3 and 7 weeks nor calcium phosphate, which binds sulfated bile acids in vitro, for 3 weeks could prevent an episode of cholestasis, although the latter normalized the bile acid pool composition. There is a rationale for a fat-restricted diet and cholestyramine therapy only as maintenance treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Bile Acids and Salts↗
PubMed1992

Intrahepatic cholestasis: a review of biochemical-pathological mechanisms.

Intrahepatic cholestasis involves impaired excretion of bile via the hepatobiliary system as a consequence of one or more lesions within the liver. In humans, intrahepatic cholestasis most often results as a side-effect of drug therapy and the clinical manifestation of this condition, jaundice, has been estimated to account for hospitalization in 2 to 5% of the cases for the general population and approaches as much as 20% in the elderly. With the aging of the population and the common occurrence of poly-drug therapy in geriatric patients, it is to be expected that jaundice due to drug-induced intrahepatic cholestasis will become even more prevalent, and accordingly the need to understand the basic mechanisms of this disease condition will become more urgent. The list of culprit agents implicated in the induction of intrahepatic cholestasis in humans is continually expanding. These include various steroid hormones, bile acids, drugs and other chemicals. Experimentally, a wide spectrum of agents has been shown to precipitate intrahepatic cholestasis. Over the years, a number of hypotheses on the biochemical and pathological mechanisms of intrahepatic cholestasis has emerged, including the following: impaired sinusoidal membrane function; interference with the distribution and binding of cytoplasmic endogenous carrier proteins; interference with mitochondrial energy supply; defects in the canalicular membrane including altered Na+/K+ -ATP-ase activity; impairment of microfilament and microtubule functions; interference with bile secretion involving bile acid dependent and independent fractions, and altered bile acid metabolism due to "hypoactive hypertrophic smooth endoplasmic reticulum". In partial agreement with the latter hypothesis, our studies indicated that impairment of the endoplasmic reticulum might represent one of the early stages in the development of intrahepatic cholestasis. Various experimental conditions that induce intrahepatic cholestasis to different degrees resulted in an interference of the synthesis of microsomal phospholipids and altered microsomal function. The conditions included the administration of various hepatotoxic compounds or steroids, pregnancy, delayed development of the endoplasmic reticulum in neonates, and dietary methyl donor or choline deficiency. This review reports the biochemical-pathological mechanisms postulated to be involved in the genesis of intrahepatic cholestasis with specific reference to experimental models of drug-induced intrahepatic cholestasis. The important practical implications of cholestasis are also briefly surveyed.

Animals↗