Vanishing bile duct syndrome

Other viruses with affinity for the liver are human immunodeficiency virus (HIV) and cytomegalovirus (CMV). CMV-DNA has been found in hepatocytes, bile ducts, and vascular cells. CMV is a dormant virus but may be reactivated, for instance, on immunosuppressive therapy after organ transplantation. It may cause vanishing bile duct syndrome and (allograft) rejection [125,126], The main... 

Cholangiodestmctive cholestasis is caused by bile duct obstruction which may be intrahepatic or extrahepatic. Bile duct injury may lead to sloughing of epithelial cells into the lumen, cell edema, and inflammation, which may contribute to obstruction (Treinen-Moslen, 2001 Plumlee, 2004). Chronic lesions associated with cholangiodestmctive cholestasis typically include bile duct prohferation and periductular fibrosis. Vanishing bile duct syndrome, characterized by a loss of bile ducts, has been seen in chronic cholestatic disease in humans (Zimmerman, 1999 Treinen-Moslen, 2001) and has been produced experimentally in dogs (Uchida, 1989). 

Uchida, H., Tomikawa, S., Nishimura, Y., Yokota, K., Sato, K., Osakabe, T., Nakayama, Y. et al. (1989). Vanishing bile duct syndrome in canine liver allotransplants. Transplant. Proc. 21 404-6. 

Occasionally, ductopenia (= vanishing bile duct syndrome) is observed. This condition is given when more than half of the portal fields in a large biopsy specimen fail to feature a bile duct. The irregular distribution of the lesions can make it very difficult to form a diagnosis based on just one biopsy specimen. The safest way is to carry out several biopsies (e. g. with the help of laparoscopy) and to make an assessment based on more than 20 portal areas. (8, 31, 93, 118, 128) (s. tabs. 29.3 29.10)... 

Tab. 29.3 Some medicaments that may provoke ductopenia (= vanishing-bile duct syndrome) in isolated cases, (s. tab. 29.10)...

Forbes, G.M., Jeffrey, G.R, Shilkin, K.B., Reed, WJ). Carbamazepine hepatotoxicity another cause of vanishing bile duct syndrome. Gastroenterology 1992 102 1385-1388... 

Yao, F., Behllng, C.A., Saab, S., Li, S., Hart, M., Lyche, K.D. Trimeth-oprim-sulfamethoxazole-induced vanishing-bile duct syndrome. Amer. J. Gastroenterol. 1997 92 167—169... 

Desmet, V.J. Vanishing bile duct syndrome in drug-induced Uver disease. J. Hepatol. 1997 26 (Suppl.) 31-35... 

Hubscher, S.G., Lumley, M.A., Elias, E. Vanishing bile-duct syndrome a possible mechanism for intrahepatic cholestasis in Hodgkin s lymphoma. Hepatology 1993 17 70-77... 

The vanishing bile duct syndrome has been associated with the use of ibuprofen in an atopic man, but the causal relation was not certain (19). 

Alam 1, Ferrell LD, Bass NM. Vanishing bile duct syndrome temporally associated with ibuprofen use. Am J Gastroenterol 1996 91(8) 1626-30. 

Dousset B, Conti F, Houssin D, Cahnus Y. Acute vanishing bile duct syndrome after interferon therapy for recurrent HCV infection in liver-transplant recipients. N Engl J Med 1994 330(16) 1160-1. 

Davies MH, Harrison RF, Elias E, Hubscher SG. Antibiotic-associated acute vanishing bile duct syndrome a pattern associated with severe, prolonged, intrahepatic cholestasis. J Hepatol 1994 20(1) 112-16. 

Morales-Diaz M +, Pharmacotherapy 19(2), 252 Vanishing Bile Duct Syndrome... 

Vanishing Bile Duct Syndrome (2004) Taghian M +, J Pediatr 145(2), 273... 

Pusl, T. and Beuers, U. (2006) Ursodeoxycholic acid treatment of vanishing bile duct syndromes. World Journal of Gastroenterology, 12 (22), 3487-3495. 

Hepatobiliary transporters are affected by both systemic inflammation (e.g., arising from an infection) and inflammation intrinsic to the liver (e.g., acute inflammatory cholestasis caused by drug or alcohol abuse). As described above, endotoxin or turpentine are used to trigger systemic inflammation in rodents. Other rodent models of cholangitis include ethinylestradiol (oral contraceptive-induced cholestasis/cholestasis of pregnancy), alpha-naphthylisocyanate (vanishing bile duct syndrome), and common bile duct ligation (extrahepatic biliary obstruction) [87, 88]. 

Chronic rejection of the liver is characterized by an obliterative arte-riopathy and the loss of bile ducts, which has been referred to as the vanishing bile duct syndrome. These patients experience an asymptomatic rise in the canalicular liver enzymes (alkaline phosphatase and Y -glutamyl transpeptidase) and become j aundiced. These changes are considered the result of immunologic and ischemic injmy and can be seen in patients who have not responded adequately to therapy for acute rejection. 

Gokqe S, Durmaz O, Celtik C, Aydogan A, Gtilluoglu M, Sbkiicu S. Valproic acid-associated vanishing bile duct syndrome. J Child Neurol 2010 25(7) 909-11. 

Biliary tract Vanishing bile duct syndrome occurred in a 60-year-old woman after she had taken meropenem for 3 weeks meropenem was withdrawn and after several months her liver function tests improved [6 ]. 

Schumaker AL, Okulicz JF. Meropenem-induced vanishing bile duct syndrome. Pharmacotherapy 2010 30(9) 953. 

Robinson W, Habr F, Manlolo J, Bhattacharya B. Moxifloxacin associated vanishing bile duct syndrome. J Clin Gastroenterol 2010 44(1) 72-3. 

Biliaiy tract Vanishing bile duct syndrome has been attributed to nevirapine in a 28-year-old pregnant woman [97" ]. 

Kochar R, Nevah Ml, Lukens FJ, Fallon MB, Machicao VI. Vanishing bile duct syndrome in human immunodeficiency virus nevirapine hepatotoxicity revisited. World J Gastroenterol 2010 16 (26) 3335-8. 

Liver Vanishing bile duct syndrome has been reported in a 62-year-old man who had had Stevens-Johnson syndrome 1 month before, after taking azithromycin 500 mg/day for 3 days liver transplantation was performed 7 months later [117 ]. 

Juricic D, Hrstic I, Radic D, Skegro M, Coric M, Vucelic B, Francetic I. Vanishing bile duct syndrome associated with azithromycin in a 62-year-old man. Basic Qin Pharmacol Toxicol 2010 106(1) 62-5. 

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