Nasobiliary drainage induces long-lasting remission in benign recurrent intrahepatic cholestasis.
Benign recurrent intrahepatic cholestasis (BRIC) is characterized by episodic cholestasis and pruritus without anatomical obstruction. Effective medical treatment is not available. We report complete and long-lasting disappearance of pruritus and normalization of serum bile salt concentrations in cholestatic BRIC patients within 24 hours after endoscopic nasobiliary drainage (NBD). Relative amounts of phospholipids and bile salts in bile collected during NBD appeared to be normal, but phospholipids other than phosphatidylcholine (especially sphingomyelin) were increased. In conclusion, we propose that temporary endoscopic nasobiliary drainage should be considered in cholestatic BRIC patients.
Stapelbroek
Janneke M
JM
Department of Pediatric Gastroenterology, University Medical Center Utrecht, The Netherlands.
van Erpecum
Karel J
KJ
Klomp
Leo W J
LW
Venneman
Niels G
NG
Schwartz
Thijs P
TP
van Berge Henegouwen
Gerard P
GP
Devlin
John
J
van Nieuwkerk
Carin M J
CM
Knisely
A S
AS
Houwen
Roderick H J
RH
D000328:Adult; D001646:Bile / Q000737:chemistry; D001647:Bile Acids and Salts / Q000032:analysis; D002780:Cholestasis, Intrahepatic / Q000628:therapy*; D004322:Drainage / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009666:Nose; D010743:Phospholipids / Q000032:analysis; D012008:Recurrence
D001647:Bile Acids and Salts; D010743:Phospholipids