Secondary sclerosing cholangitis in patients with drug-induced liver injury

Gudnason, Hafsteinn Oli; Björnsson, Helgi; Gardarsdottir, Marianna; Thorisson, Hjalti M.; Ólafsson, Sigurđur; Bergmann, Ottar M.; Bjõrnsson, Einar

doi:10.1016/j.dld.2015.03.002

Cited by 47 publications

(46 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, recently secondary sclerosing cholangitis with diffuse inflammatory stricturing of the biliary tree on magnetic resonance cholangiopancreatography (MRCP) or endoscopic retrograde cholangiopancreatography (ERCP) has been described in a small proportion of patients presenting with acute cholestatic DILI. 193 In this series, all 10 patients were women with a cholestatic or mixed pattern of DILI, 70%…”

Section: Recommendationmentioning

confidence: 74%

“…However, morphological changes have been reported in the hepatic parenchyma and the biliary tree in patients with DILI. 170,193,[246][247][248][249][250][251][252][253][254][255][256] Sclerosing cholangitislike changes on imaging have been described with chemotherapeutic agents such as 5-fluorodeoxyuridine after hepatic intra-arterial infusions for treatment of hepatic metas- tases. 249,[254][255][256] Cholangiopathy is well documented after abuse of ketamine, both small duct changes and cholangiographic abnormalities.…”

Section: Imagingmentioning

confidence: 99%

See 1 more Smart Citation

EASL Clinical Practice Guidelines: Drug-induced liver injury

Andrade¹,

Aithal²,

Bjõrnsson³

et al. 2019

Journal of Hepatology

Self Cite

666

394

View full text Add to dashboard Cite

Idiosyncratic (unpredictable) drug-induced liver injury is one of the most challenging liver disorders faced by hepatologists, because of the myriad of drugs used in clinical practice, available herbs and dietary supplements with hepatotoxic potential, the ability of the condition to present with a variety of clinical and pathological phenotypes and the current absence of specific biomarkers. This makes the diagnosis of drug-induced liver injury an uncertain process, requiring a high degree of awareness of the condition and the careful exclusion of alternative aetiologies of liver disease. Idiosyncratic hepatotoxicity can be severe, leading to a particularly serious variety of acute liver failure for which no effective therapy has yet been developed. These Clinical Practice Guidelines summarize the available evidence on risk factors, diagnosis, management and risk minimization strategies for drug-induced liver jury.

show abstract

Section: Recommendationmentioning

confidence: 74%

Section: Imagingmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Drug-induced liver injury

Andrade¹,

Aithal²,

Bjõrnsson³

et al. 2019

Journal of Hepatology

Self Cite

666

394

View full text Add to dashboard Cite

show abstract

“…Sclerosing cholangitis is a group of chronic cholestatic disorders affecting the intra- and/or extrahepatic biliary tree, which can lead to biliary cirrhosis and liver failure 1–11. Sclerosing cholangitis can be divided into the more well-known primary sclerosing cholangitis (PSC), which is an idiopathic form mostly associated with inflammatory bowel disease,12,13 and secondary sclerosing cholangitis (SSC), the acquired form where the etiology can usually be identified 14.…”

Section: Introductionmentioning

confidence: 99%

“…Sclerosing cholangitis can be divided into the more well-known primary sclerosing cholangitis (PSC), which is an idiopathic form mostly associated with inflammatory bowel disease,12,13 and secondary sclerosing cholangitis (SSC), the acquired form where the etiology can usually be identified 14. Infections, toxicity, and ischemia of the bile ducts are the most common causes of SSC 1–11. A recently recognized form of SSC has been observed in patients after long treatment in intensive care units (ICUs) called secondary sclerosing cholangitis in critically ill patients (SSC-CIP).…”

Section: Introductionmentioning

confidence: 99%

Secondary sclerosing cholangitis in critically ill patients: current perspectives

Gudnason¹,

Bjõrnsson²

2017

CEG

Self Cite

View full text Add to dashboard Cite

Secondary sclerosing cholangitis (SSC) is a term used for a group of chronic cholestatic disease affecting the intra- and/or extrahepatic biliary tree with inflammation and progressive stricture formation, which can lead to biliary cirrhosis. A newly recognized form of SSC is secondary sclerosing cholangitis in critically ill patients (SSC-CIP). Pathogenesis is believed to involve ischemic injury of intrahepatic bile ducts associated with prolonged hypotension, vasopressors administration, and/or mechanical ventilation in patients treated in the intensive care unit (ICU). Patients diagnosed with SSC-CIP have no prior history of liver disease and no known pathologic process or injury responsible for bile duct obstruction prior to ICU treatment. Reasons leading to ICU treatment are many including multitrauma, burn injury, cardiac surgery, severe pneumonia, other infections, or bleeding after abdominal surgery. Patients have in common prolonged ICU admission. SSC-CIP is associated with rapid progression to liver cirrhosis and poor survival with limited treatment options except a liver transplantation. Transplant-free survival is around 17–40 months, which is lower than in other SSC patients. During the initial stages of the disease, the clinical symptoms and biochemical profile are not specific and easily missed. Biliary casts formation may be considered pathognomonic for SSC-CIP since most patients have them in early stages of the disease. Increased awareness and early detection of the disease and its complications is considered to be crucial to improve the poor prognosis.

show abstract

“…These patients had more severe cholestatic/mixed DILI at presentation as compared with those without strictures in MRCP. 69 This intriguing observation remains to be independently validated.…”

Section: Which Information Should Be Retrieved To Confidently Qualifymentioning

confidence: 96%

Hepatic Damage by Natural Remedies

et al. 2018

View full text Add to dashboard Cite

The rising burden of herbal and dietary supplement hepatotoxicity (HILI) is a growing concern in Western countries. The estimated incidence of HILI in well-designed prospective studies ranges from less than 1 to 3 individuals per 100,000 inhabitants/year. Herbal hepatotoxicity has a particular signature encompassing female predominance, hepatocellular type of damage with markedly elevated transaminases on presentation, more common unintentional rechallenge, and a greater risk of death/liver transplantation. Herbal hepatotoxicity recognition is particularly challenging for hepatologists because of the often hidden herbal consumption, difficulties in identifying the causative herbal component, and the possibility of contamination, adulteration, and misidentification, which preclude a proper adjudication and lead to inaccurate reporting of cases in scientific journals. Collaborative efforts to retrieve detailed phenotypic data and biological samples of patients with HILI would facilitate genomic and other molecular approaches for a better understanding of host risk factors and, hopefully, for biomarker identification.

show abstract

Secondary sclerosing cholangitis in patients with drug-induced liver injury

Cited by 47 publications

References 25 publications

EASL Clinical Practice Guidelines: Drug-induced liver injury

EASL Clinical Practice Guidelines: Drug-induced liver injury

Secondary sclerosing cholangitis in critically ill patients: current perspectives

Hepatic Damage by Natural Remedies

Contact Info

Product

Resources

About