Vanishing bile duct syndrome in human immunodeficiency virus: Nevirapine hepatotoxicity revisited

Abstract

Vanishing bile duct syndrome (VBDS) refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance of intrahepatic bile ducts. Multiple etiologies have been indentified including infections, neoplastic disorders, autoimmune conditions and drugs. The natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage. VBDS is extremely rare in human immunodeficiency virus (HIV)-infected patients and anti-retroviral therapy has never been implicated as a cause. We encountered a young pregnant female with HIV and VBDS secondary to anti-retroviral therapy. Here, we report her clinical course and outcome.

Co‐occurrence of cytomegalovirus‐induced vanishing bile duct syndrome with papillary stenosis in HIV infection

“…VBDS is rare in HIV infection; prior to this case, only two reports have documented VBDS in HIV infected patients. CMV infection was the etiologic factor in one case, whereas nevirapine was the offending drug in another report 3,4 . The unique feature of this case is the simultaneous occurrence of VBDS and papillary stenosis, which to the best of our knowledge has not been documented earlier.…”

“…The occurrence of VBDS in HIV infection is uncommon and has been recorded only in two previous case reports. VBDS in AIDS can be due to opportunistic infections or drugs used for the treatment of AIDS 3,4 . Herein, we describe a rare case of cholestatic liver disease having the dual pathology of intrahepatic cholestasis due to VBDS and extrahepatic biliary obstruction due to papillary stenosis.…”

Aberrant Confluence of Intrahepatic Biliary Ducts - A Case Report

“…As to the absence of first ductules, it is important for clinical practice for two reasons: the first as a sign of fibro-obliterative deseases [18][19][20][21][22][23][24][25][26] and the second considering minimum detectable duct caliber in imaging radiologic researches [27][28][29]. From LDLT point of view it is important in evaluation of age and functional-size-mass related liver parenchyma changes for donors and recipients.…”

Medicamentos causantes de hepatotoxicidad en el embarazo: revisión estructurada

“…Las reacciones tóxi-cas pueden aparecer entre los 10 y los 280 días de iniciado el tratamiento (23)(24)(25)(26). La hepatotoxicidad se ha presentado en pacientes con edad entre los 18 y 45 años (21, 24-27), con elevación de las transaminasas y rash (23,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37).…”

“…La hepatotoxicidad se ha presentado en pacientes con edad entre los 18 y 45 años (21, 24-27), con elevación de las transaminasas y rash (23,(26)(27)(28)(29)(30)(31)(32)(33)(34)(35)(36)(37). Se presentó 1 caso de ductopenia, caracterizado por un tipo de lesión colestásica (25). El manejo se fundamenta en la suspensión de la nevirapina y cambio en la farmacoterapia (23,(26)(27)(28)(29).…”