Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0008370 (cholestasis)
 9,378 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The first case of hepatic injury induced by Venoplant, extracts of Aesculus Hippocastanum, having antiinflammatory activities, was described. A 37 yr-old man was admitted for treatment of pathological fracture of the left brachial bone. He had been received 65 mg Venoplant at another hospital several hours before admission. 17 days later, a liver function test showed mild abnormality and 60 days after injection, he complained of pruritus and jaundice. Laboratory studies revealed moderate elevation of total bilirubin, ALP, gamma-GTP and mild eosinophilia. CT studies and ERC showed no signs of extrahepatic obstructive jaundice. The lymphocyte stimulation test was positive. The liver biopsy demonstrated marked cholestasis with zonal necrosis in the centrilobular areas but showed little or no changes in the portal tracts. These features are consistent with drug-induced hepatic injury.
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PMID:A case of Venoplant-induced hepatic injury. 369 1

Little is known of the effect of cholestasis on host immunity. This study evaluates lymphocytic responsiveness to PHA and LPS mitogen and to allogeneic F344 antigen in Sprague-Dawley rats 21 days following bile duct ligation and 31 days following relief of jaundice by internal biliary drainage. Serum bilirubin level was significantly elevated in the bile duct ligated animals at Day 21 (P less than 0.001) and thereafter returned to preoperative levels following internal biliary drainage. Results demonstrate depressed responsiveness to PHA (P less than 0.001) and allogeneic F344 antigen in vivo (P less than 0.04) and in vitro (P less than 0.02) in bile duct ligated animals as compared to sham, sham pair-fed, and normal control rats. The observed deficiency in responsiveness to T-cell-dependent mitogen and antigen cannot be explained on the basis of complicating nutritional, renal, or infective factors. Subsequent internal biliary drainage results in some improvement in T-cell responsiveness in the bile duct ligated group although recovery is not complete. B-Lymphocytic response to LPS mitogen is not affected by bile duct ligation. We conclude that cholestasis subsequent to extrahepatic biliary obstruction per se results in impairment of cell-mediated immunity in vivo. This impairment is partly reversible by internal biliary drainage. In vitro B-cell function does not appear to be affected in this model. Further study of impaired cell-mediated immunity in extrahepatic biliary obstruction will improve our understanding of the immunological status of patients with obstructive jaundice and cholestatic liver diseases.
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PMID:Impaired specific cell-mediated immunity in experimental biliary obstruction and its reversibility by internal biliary drainage. 376 22

The serum levels of apolipoprotein A-IV (apo A-IV) were measured by rocket immunoelectrophoresis in disease-free humans, at fasting and after oral and intravenous fat administration. The studies were extended to patients with chronic pancreatitis, malabsorption syndrome, to postoperative patients on total parenteral nutrition and to patients with liver diseases, cholestasis, diabetes mellitus and chronic renal failure. Oral fat ingestion resulted in an increase of apo A-IV levels which remained elevated even when the postprandial hypertriglyceridemia had disappeared. A transient increase in apo A-IV levels was observed after intravenous fat infusion but the level declined simultaneously with decreases in triglyceride levels. Levels of serum apo A-IV were decreased under conditions where decreased fat intake or malabsorption of nutrients might have been present, such as in patients with chronic pancreatitis, malabsorption syndrome, acute hepatitis in the early stage, obstructive jaundice and in postoperative patients on total parenteral nutrition. On the other hand, the apo A-IV levels were high in patients with chronic renal failure and in those with diabetes mellitus and proteinuria.
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PMID:Alterations in plasma levels of apolipoprotein A-IV in various clinical entities. 378 Nov 71

We studied the effect of jaundice on in vitro vascular reactivity to cumulative doses of norepinephrine (NE) by measuring the maximal response (Rmax) and the concentration of NE required to cause a 50% response (ED50) of isolated vascular smooth muscle. For this we prepared helically cut strips of thoracic aorta from bile duct ligated (BDL) rats at 1, 3, 6, 14, and 28 days postligation and compared them with those of nonoperated and sham-operated controls. From 1 to 6 days post-BDL, changes in liver blood chemistry and liver histology indicated cholestasis with necrosis. By 14 days, the tests for liver function and histology indicated a return to normal liver function and histology. In nonoperated controls, mean Rmax increased significantly from 883 +/- 67 mg of tension to 1220 +/- 68 mg of tension (P less than 0.0025) from 0 to 28 days, whereas ED50 remained unchanged. In sham-operated controls and BDL rats, an age-dependent increase in Rmax was also observed. However, in the sham groups, ED50 tended to decrease compared with nonoperated controls, indicating a surgically induced "sensitization" phenomenon of the vascular smooth muscle. In contrast, this was not seen in BDL rats since in these groups, the ED50 remained unchanged and significantly higher than in the sham groups, in both the jaundiced (1-6 days) and nonjaundiced (14-28 days) period. Furthermore, these changes occurred in the absence of any alteration in portal pressure. These changes may be important in understanding the mechanism of hypotension and shock in postoperative patients with obstructive jaundice even after the jaundice has been relieved.
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PMID:Vascular reactivity in reversible experimental obstructive jaundice. 382 Oct 86

A patient receiving total parenteral nutrition (TPN) at home following emergency resection of the small intestine was studied over a two year interval. Cholestatic jaundice developed after 6 months. A factor in serum was found to produce cholestatic changes in the bile flow of rats on intravenous infusion. Normal human serum and saline infusion did not produce this cholestasis. Endotoxin infusion in the rat produced a similar impairment in bile flow. The hypothesis was proposed that endotoxin might be an occult factor contributing to cholestasis in this case. An antiserum prepared to an endotoxin isolated from a sequestered E. coli infection in this patient, ameliorated the cholestatic effects of the patients' serum in rats. The possible role of endotoxin in the cholestasis of the TPN-induced jaundice in this patient is presented and discussed.
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PMID:Hyperalimentation-associated jaundice: an example of a serum factor inducing cholestasis in rats. 391

In a newborn baby with Hirshsprung's disease obstructive jaundice developed following prolonged parenteral nutrition. At laparotomy, thick inspissated bile was flushed from the biliary tree and prompt resolution of the jaundice followed. To our knowledge, this is the first reported case in which inspissated bile appeared to be a complication of total parenteral nutrition. Mechanical obstruction must be recognized as an extreme in the spectrum of total parenteral nutrition cholestasis.
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PMID:Total parenteral nutrition cholestasis: a cause of mechanical biliary obstruction. 393 38

Combined determination of serum lipoprotein-X and electrophoretic separation of high molecular mass (HMr) alkaline phosphatase has been proposed as a marker for the differential diagnosis between intrahepatic cholestasis and extrahepatic obstructive jaundice. Of 32 patients who were known to be lipoprotein-X positive and in whom a definitive diagnosis had been made, 13 had intrahepatic cholestasis and 17 extrahepatic obstruction, and 2 had both intrahepatic and extrahepatic obstruction. The detection of HMr alkaline phosphatase isoenzyme proved to be a sensitive and specific test for detecting liver disease, particularly obstructive liver disease. The diagnostic significance of the combined determination of serum lipoprotein-X to demonstrate or exclude cholestasis and electrophoretic separation of HMr alkaline phosphatase isoenzymes to allow differentiation between intrahepatic cholestasis and extrahepatic obstruction was investigated.
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PMID:The value of combined determination of high molecular mass API and LP-X in the differential diagnosis of intrahepatic and extrahepatic obstruction. 404 56

104 patients with obstructive jaundice were referred for percutaneous transhepatic cholangiography (PTC) and percutaneous transhepatic biliary drainage (PTBD). The effects of PTBD on postoperative morbidity and mortality were evaluated as well as the occurrence of complications. The results were compared to a group of 33 patients with malignant bile duct obstruction operated without preoperative bile drainage. There was no significant difference in the rate of postoperative complications and mortality between these two groups.
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PMID:Evaluation of percutaneous cholangiography and percutaneous biliary drainage in obstructive jaundice. 408 89

Conjugates of bilirubin were studied in normal bile of man and rat, and in bile of liver patients. In general human bile was obtained by duodenal intubation. In addition T-tube bile was examined in patients operated on for mechanical obstruction. The bile pigment compositions of duodenal and T-tube bile were similar in two patients where comparison was possible. Obstruction of the bile duct in rats was used as an animal model for obstructive jaundice. Diazotized ethyl anthranilate was used for determination of total conjugated bile pigment and for thin-layer chromatography (t.l.c.) analysis of the derived azopigments. The available t.l.c. procedures are versatile and allow rapid and quantitative analysis. A variety of conjugated azopigments can be distinguished. With chloroform, negligible amounts of unconjugated bilirubin are extracted from bile of man. Therefore, the percentage of monoconjugated bile pigments present in the initial bile sample can be calculated from the percentage of azodipyrrole found after diazotization. Normal bile from man and rat yields similar azopigment patterns. The dominant component is azopigment-delta (azodipyrrole beta-D-monoglucuronoside). Small amounts of azopigments with complex conjugating structures (gamma-azopigments) are present in both cases. Human bile further yields small amounts of azopigments containing xylose or glucose (called azopigments-alpha(2) and -alpha(3), respectively). Monoconjugated bilirubin (estimated from the percentage of azodipyrrole) amounts of 22% of total bile pigments in human bile and to 39% in murine bile. In both, the bulk of bile pigment is bilirubin diglucuronoside. From bile of patients with acquired liver diseases a new azopigment group (beta-azopigment) was derived. The gamma-azopigment group was increased; the delta-azopigment group (containing azodipyrrole beta-D-monoglucuronoside) was decreased. No differentiation was possible between intra- and extrahepatic cholestasis. The percentage of beta-azopigment showed a positive correlation with serum bilirubin concentration (r = 0.6). Recovery of the diseases was accompanied by normalization of the azopigment patterns. In rats, hydrostatic or mechanical obstruction induced increases in beta- and gamma-azopigments and a decrease in delta-azopigment similar to the changes observed in bile of liver patients. Complete normalization was obtained 6 hr after relieving the hydrostatic obstruction (duration 15-21 hr). In contrast, with man after surgery for extrahepatic obstruction, T-tube bile was not normalized when the T-tube was withdrawn (10 days after operation). Hydrostatic obstruction in rats provides an easy model when postobstructive bile pigment composition and parameters have to be investigated. The present investigations stress the importance of the physiopathological state when studying bilirubin conjugation. Hindrance to bile secretion induced heterogeneity of bilirubin conjugates and stimulated the formation of complex structures.
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PMID:Bilirubin conjugates in bile of man and rat in the normal state and in liver disease. 463 28

An abnormal lipoprotein, containing a high proportion of unesterified cholesterol and phospholipid, has previously been described as occurring in the serum of patients with obstructive jaundice, and has been called lipoprotein X. Using an immunoelectrophoretic method for the detection of lipoprotein X in serum, the sera of 97 patients with liver disease have been screened and the associated biochemical features measured.Lipoprotein X was found in 45% of cases of liver disease with cholestatic features, and was not detected in cases of liver disease without cholestasis. The incidence of lipoprotein X in different causes of cholestatis varied, and while it was commonest in cases of extrahepatic obstruction of recent onset, occurring in 75% of cases, it was also found in primary biliary cirrhosis in 48% of cases, and in cholestatic hepatitis, less commonly.The cause of the appearance of lipoprotein X is unknown, but analysis of associated biochemical features suggested a relationship to physical biliary obstruction rather than a derangement of liver cell function.
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PMID:Occurrence of an abnormal lipoprotein in patients with liver disease. 551 83


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