Plasma exchange in primary biliary cirrhosis

Keeling, P. W. N.; Kingston, Pauline; Bull, J.; Thompson, R. P. H.

doi:10.1136/pgmj.57.669.433

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Adams D Clements and E Elias1

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1984

2013

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Cited by 10 publications

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“…Eight patients with chronic cholestasis found relief for 24h to 5 months after extracorporeal charcoal column perfusion (55). Plasmapheresis has also been shown to improve refractory pruritus, although only for as long as the procedure is continued (56,57). These methods are costly, and not routinely available.…”

Section: Adams D Clements and E Eliasmentioning

confidence: 99%

The Treatment of Primary Biliary Cirrhosis

1986

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Section: Adams D Clements and E Eliasmentioning

confidence: 99%

The Treatment of Primary Biliary Cirrhosis

1986

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Intrahepatic cholestasis and phospholipidosis associated with the use of trimethoprim-sulfamethoxazole

1990

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Although liver injury after administration of the trimethoprim-sulfamethoxazole combination is rare, hepatocellular necrosis and cholestasis have developed in a few cases. We describe a patient who developed a severe, prolonged cholestatic reaction after trimethoprim-sulfamethoxazole administration. The findings from serial liver biopsy samples showed characteristic abnormalities of phospholipidosis that have not been previously described for trimethoprim-sulfamethoxazole-related hepatic injury. The most prominent finding on electron microscopic evaluation of the liver was the presence of prominent hepatocyte lysosomal inclusions characterized by concentric arrangements of membranous and lamellated structures. The patient improved after several courses of exchange plasmapheresis, which may have assisted in the removal of toxic drug-lipid complexes. The pathogenesis of this acquired secondary phospholipidosis is unknown. Possible mechanisms include generation of highly lipid-soluble metabolites and inhibition of the lysosomal enzyme phospholipase A1.

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