Abstract
Obstructive dominant biliary strictures are considered irreversible lesions in patients with primary sclerosing cholangitis; therapy with ursodeoxycholic acid has been shown to determine clinical, biochemical and histological improvement in such patients. To date, two reports of anatomical improvement of biliary tract lesions during ursodeoxycholic acid therapy have been published. We observed a 19-year-old male patient with primary sclerosing cholangitis who presented with severe cholestasis due to an obstructive dominant stricture of the common hepatic duct and absence of biliary excretion at cholescintigraphy. Oral administration of 900 mg/day ursodeoxycholic acid was followed by rapid decrease of jaundice and a normalization of life activity. Twelve months later a repeat cholescintigraphy showed normal biliary excretion. Despite continuing therapy, two years later the patient needed liver transplantation because of recurring severe obstructive jaundice. This report suggests that ursodeoxycholic acid may reverse a severe cholestatic syndrome in the course of primary sclerosing cholangitis despite a dominant stricture in the biliary tree. The mechanisms responsible for this effect are still obscure, but may involve restoration of bile flow through the biliary stricture. The late relapse during continuing therapy suggests that - at least in some patients - these effects may be temporary and ursodeoxycholic acid may lose its efficacy in the long term.
| Original language | English |
|---|---|
| Pages (from-to) | 430-435 |
| Number of pages | 6 |
| Journal | Italian Journal of Gastroenterology |
| Volume | 27 |
| Issue number | 8 |
| Publication status | Published - 1995 |
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Keywords
- Biliary tree strictures
- Cholestasis
- Primary
- Sclerosing cholangitis
- Ursodeoxycholic acid
ASJC Scopus subject areas
- Gastroenterology
Cite this
Temporary resolution of obstructive jaundice during ursodeoxycholic acid therapy in a patient with primary sclerosing cholangitis and a dominant biliary stricture. / Fracchia, M.; Soubrane, O.; Houssin, D.; Galatola, G.
In: Italian Journal of Gastroenterology, Vol. 27, No. 8, 1995, p. 430-435.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Temporary resolution of obstructive jaundice during ursodeoxycholic acid therapy in a patient with primary sclerosing cholangitis and a dominant biliary stricture
AU - Fracchia, M.
AU - Soubrane, O.
AU - Houssin, D.
AU - Galatola, G.
PY - 1995
Y1 - 1995
N2 - Obstructive dominant biliary strictures are considered irreversible lesions in patients with primary sclerosing cholangitis; therapy with ursodeoxycholic acid has been shown to determine clinical, biochemical and histological improvement in such patients. To date, two reports of anatomical improvement of biliary tract lesions during ursodeoxycholic acid therapy have been published. We observed a 19-year-old male patient with primary sclerosing cholangitis who presented with severe cholestasis due to an obstructive dominant stricture of the common hepatic duct and absence of biliary excretion at cholescintigraphy. Oral administration of 900 mg/day ursodeoxycholic acid was followed by rapid decrease of jaundice and a normalization of life activity. Twelve months later a repeat cholescintigraphy showed normal biliary excretion. Despite continuing therapy, two years later the patient needed liver transplantation because of recurring severe obstructive jaundice. This report suggests that ursodeoxycholic acid may reverse a severe cholestatic syndrome in the course of primary sclerosing cholangitis despite a dominant stricture in the biliary tree. The mechanisms responsible for this effect are still obscure, but may involve restoration of bile flow through the biliary stricture. The late relapse during continuing therapy suggests that - at least in some patients - these effects may be temporary and ursodeoxycholic acid may lose its efficacy in the long term.
AB - Obstructive dominant biliary strictures are considered irreversible lesions in patients with primary sclerosing cholangitis; therapy with ursodeoxycholic acid has been shown to determine clinical, biochemical and histological improvement in such patients. To date, two reports of anatomical improvement of biliary tract lesions during ursodeoxycholic acid therapy have been published. We observed a 19-year-old male patient with primary sclerosing cholangitis who presented with severe cholestasis due to an obstructive dominant stricture of the common hepatic duct and absence of biliary excretion at cholescintigraphy. Oral administration of 900 mg/day ursodeoxycholic acid was followed by rapid decrease of jaundice and a normalization of life activity. Twelve months later a repeat cholescintigraphy showed normal biliary excretion. Despite continuing therapy, two years later the patient needed liver transplantation because of recurring severe obstructive jaundice. This report suggests that ursodeoxycholic acid may reverse a severe cholestatic syndrome in the course of primary sclerosing cholangitis despite a dominant stricture in the biliary tree. The mechanisms responsible for this effect are still obscure, but may involve restoration of bile flow through the biliary stricture. The late relapse during continuing therapy suggests that - at least in some patients - these effects may be temporary and ursodeoxycholic acid may lose its efficacy in the long term.
KW - Biliary tree strictures
KW - Cholestasis
KW - Primary
KW - Sclerosing cholangitis
KW - Ursodeoxycholic acid
UR - http://www.scopus.com/inward/record.url?scp=0029609006&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0029609006&partnerID=8YFLogxK
M3 - Article
C2 - 8775469
AN - SCOPUS:0029609006
VL - 27
SP - 430
EP - 435
JO - Italian Journal of Gastroenterology
JF - Italian Journal of Gastroenterology
SN - 0392-0623
IS - 8
ER -