Cholestasis

Consensus on the diagnosis and treatment of cholestatic liver diseases (2015, China)

“…When bile excretion is not smooth, the inner pressure of the bile canaliculi increases to induce an increased ALP production. In addition, bile acid uses its surface activity function to elute ALP from lipid membranes to significantly increase serum ALP …”

“…During cholestasis, the level of bile acid is higher than 10 µmol/L. A bile acid level of 10‐20 µmol/L represents a mild increase, 20–40 µmol/L represents a moderate increase, and above 40 µmol/L is a severe increase . Additionally, cholylglycine (one type of glycine‐conjugated bile acids) assay has entered clinical application.…”

“…Cholestasis and jaundice are not exactly the same. Cholestasis includes stasis of all bile components, including bilirubin . Jaundice is a phenomenon of increases in blood bilirubin concentrations, thus causing yellow staining of tissues such as sclera and skin.…”

“…At the early stage of the disease, patients are usually asymptomatic, and the only presentation is an increase in alkaline phosphatase (ALP) and gamma‐glutamyl transferase (GGT) levels. After disease progression, patients can present with hyperbilirubinemia; when severe, it can cause liver failure or even death . Hepatobiliary diseases with the major presentation of cholestasis caused by a variety of reasons are collectively referred to cholestatic liver diseases.…”