Temporary resolution of obstructive jaundice during ursodeoxycholic acid therapy in a patient with primary sclerosing cholangitis and a dominant biliary stricture

M. Fracchia, O. Soubrane, D. Houssin, G. Galatola

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1 Citation (Scopus)

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 languageEnglish
Pages (from-to)430-435
Number of pages6
JournalItalian Journal of Gastroenterology
Volume27
Issue number8
Publication statusPublished - 1995

Fingerprint

Ursodeoxycholic Acid
Sclerosing Cholangitis
Obstructive Jaundice
Pathologic Constriction
Biliary Tract
Therapeutics
Common Hepatic Duct
Cholestasis
Jaundice
Bile
Liver Transplantation
Oral Administration
Recurrence

Keywords

  • Biliary tree strictures
  • Cholestasis
  • Primary
  • Sclerosing cholangitis
  • Ursodeoxycholic acid

ASJC Scopus subject areas

  • Gastroenterology

Cite this

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title = "Temporary resolution of obstructive jaundice during ursodeoxycholic acid therapy in a patient with primary sclerosing cholangitis and a dominant biliary stricture",
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.",
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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.

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