Cholangitis, treatment

Van den Hazel SJ, Speelman P, Tytgat GNJ, Dankert J, Van Leeuwen DJ Role of antibiotics in the treatment and prevention of acute and recurrent cholangitis. Clin Infect Dis 1994 19 279-286. 

Unlabeled Uses Prophylaxis of liver transplant rejection, treatment of alcoholic cirrhosis, biliary atresia, chronic hepatitis, gallstone formation, sclerosing cholangitis... 

Jessen, K., A1 Mofleh, I., AI Moferreh, M. Endoscopic treatment of ascariasis causing acute obstructive cholangitis. Hepatogastroenterol. 1986 33 275-277... 

Pereira-Lima, J.C., Jacobs, R., da Silva, C.R, Coral, G.R, da Silveira, L.L., Rynkowski, C.B., Riemann, JJ . Endoscopic removal of Ascaris lumbricoides from the bihary tract as emergency treatment for acute suppurative cholangitis. Z. Gastroenterol. 2001 39 793-796... 

Standard therapy Intensive care treatment and monitoring is accepted as standard therapy complications may appear unexpectedly and rapidly. In about 75% of patients with mild cholangitis, therapeutic success can be achieved by the substitution of fluid, electrolytes and zinc as well as vitamins, glucose (possibly also amino acids) and the (indispensable) administration of antibiotics. Analgesics and spasmolytics are generally necessary. In addition, the administration of fresh plasma is recommended to stabilize haemostasis. 

The chnical picture of autoimmune cholangitis (AIC) was described by G. Brunner and O. Klinge in 1987. (452) AH patients were women. A genetic disposition was assumed, as all examined daughters and one granddaughter of the female patients had increased ANA and SMA titres as well (with AMA negativity). Treatment with azathioprine and prednisolone was successful. 

Gogel, H.K., Runyon, B.A., Volpicelli, N.A., Palmer, R.C Acute suppurative obstructive cholangitis due to stones treatment by urgent endoscopic sphincterotomy. Gastrointest. Endosc. 1987 33 210—213... 

Ursodeoxycholic acid for treatment of primary sclerosing cholangitis A placebo-controlled trial. Hepatology 1992 16 707-714... 

Knox, T.A., Kaplan, M.M. A double-blind controlled trial of oral pulse methotrexate therapy in the treatment of primary sclerosing cholangitis. Gastroenterology 1994 106 494 - 499... 

S., Nakao, A., Morise, K. Successful treatment of primary sclerosing cholangitis with cyclosporine and corticosteroid. Hepato-Gastroenterol. 1994 41 449-452... 

Lo, S.K., Fleming, K., Chapman, R.W.G. A 2-year follow-up study of anti-neutrophil antibody in primary sclerosing cholangitis relationship to clinical activity, Uver biochemistry and ursodeoxycholic acid treatment. J. Hepatol. 1994 21 974-978... 

O Brien, C.B., Senior, J.R., Arora-Mirchandani, R., Batta, A.K., Salen, G. Ursodeoxycholic acid for the treatment of primary sclerosing cholangitis A 30-month pilot study. Hepatology 1991 14 838-847... 

Stiehl, A., Rudolph, G., Sauer, R, Benz, C., Stremmel, W., Walker, S., Theilmann, L. Efficacy of ursodeoxycholic acid treatment and endoscopic dilation of major duct stenoses in primary sclerosing cholangitis. An 8-year prospective study. X Hepatol. 1997 26 560-566... 

Interferon The occurrence of AIH during the treatment of chronic hepatitis B with interferon has already been described (13), as have manifestations and new episodes of inflammation caused by interferon in patients with AIH and chronic hepatitis C. (32, 66, 78) The indication for interferon therapy has to be considered with caution in cases of chronic viral hepatitis with concurrent AIH or autoimmune cholangitis it should also be monitored with great care. In replicative chronic hepatitis B, B/D or C, the chronic viral hepatitis constitutes the major factor - whereas AIH is seen as a concomitant phenomenon. Immunosuppressive therapy is not indicated. In addition, as recent studies show, there are also differences within the HCV infection itself for example, 90% of HCV carriers in Japan and 20% of those in the USA and Germany are at the same time HGV carriers (GB-C). The GB-C and HGV hepatitis viruses are designated defective because they require completion by the helper virus HCV. (s. p. 450)... 

Fundamentally, treatment of cirrhosis should begin during its chronic precursory stages, i. e. chronic hepatitis or chronic cholangitis. A chronic disease confirmed by detailed diagnostics usually still responds to effective treatment measures, which are, however, of no help once the cirrhotic stage has been reached. 

Olsson, R., Broome, IX, Danielsson, A., Hagerstrand, I., Jarnerot, G., Loof, L., lYytz, H., Ryden, B.-0., Wallerstedt, S. Colchicine treatment of primary sclerosing cholangitis. Gastroenterology 1995 108 1199-1203... 

High-dose ursodeoxycholic acid (20 mg/kg/day) has been compared with placebo in the treatment of primary sclerosing cholangitis in a 2-year double-blind preliminary study in 26 patients (5). High-dose ursodeoxycholic acid did not influence symptoms, but... 

Three cases of secondary sclerosing cholangitis developed during the early postoperative phase of surgical treatment of hydatid liver cysts in which formaldehyde was used one... 

Angulo P, Bharucha AE, Jorgensen RA, DeSotel CK, Sandborn WJ, Larusso NF, Lindor KD. Oral nicotine in treatment of primary sclerosing cholangitis a pilot study. Dig Dis Sci 1999 44(3) 602-7. 

Allopurinol (4-hydroxypyrazolo [3, 4-d] pyrimidine) is an inhibitor of xanthine oxidase that was successfully introduced in the treatment of primary gout about 45 years ago [171]. Allopurinol continues to be accepted as standard therapy in the treatment of primary and secondary hyperuricemia. Adverse reactions occur in about 10% of patients treated with allopurinol and are relatively mild and self-limited [171,172]. A mild maculopapular eruption or gastrointestinal disorders are usually noted, which promptly regress with cessation of therapy. Isolated instances of allopecia [173], bone marrow depression [174], ocular lesions [175], acute cholangitis [176], various types of hepatic injuries [177,178] temporal arthritis [179], and xanthine stones [180] have been reported. Recently, LaRosa et al [180a] have reported a case of xanthine nephropathy during treatment of childhood T-cell ALL. 

Korting FIC, Lesch R. Acute cholangitis after allopurinol treatment. Lancet 1978 1 275-276. 

Lee Y, Kaplan M. Treatment of primary biliary cirrhosis and primary sclerosing cholangitis Use of ursodeoxycholic acid. Curr Gastroenterol Rep 1999 1 38-41. 

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