title: [Sepsis as a cause of intrahepatic cholestasis].
abstract: BACKGROUND
  The causes of intrahepatic cholestasis include cholestatic viral hepatitis, primary biliary cirrhosis, benign recurrent cholestasis, primary sclerosing cholangitis and sepsis. During sepsis, proinflammatory cytokines and nitric oxide cause cholestasis by impairing hepatocellular and ductal bile formation.
  
  
  METHODS
  We report a 48-year-old woman who was admitted to hospital due to malaise, jaundice, fever and pain in the neck. Physical examination revealed jaundice, tachycardia (pulse rate was 120/min), hypotension 90/60 mm Hg. Laboratory findings showed normocytic normochromic anaemia, inflammatory syndrome and abnormal liver function tests indicating cholestasis and hepatocellular necrosis. Abdominal ultrasonography detected hepatosplenomegaly. Chest computed tomography showed bronchopneumonic infiltrates. Percutaneous liver biopsy was performed using a Menghini needle of 1.4 mm. Pathohystological analysis of the liver tissue confirmed reactive, intrahepatic cholestasis. Blood cultures isolated Staphylococcus aureus. After the diagnosis was established the treatment with broad-spectrum antibiotics was carried out, resulting in the improvement of general condition of the patient, regression of inflammatory syndrome, disappearance of cholestasis and regression of pulmonary infiltrates. Abdominal ultrasonography after antibiotic treatment did not show hepatosplenomegaly.
  
  
  CONCLUSIONS
  Concerning patients with cholestasis of uncertain origin, we should always think of sepsis as a possible cause in order to start antibiotic treatment in time.
authors: Jelena
authors: J
authors: Rudić
authors: Rada
authors: R
authors: Jesić
authors: Djordje
authors: D
authors: Culafić
authors: Radmila
authors: R
authors: Sarenac-Kovac
authors: Vladislava
authors: V
authors: Bulat
authors: Tatjana
authors: T
authors: Cvejić
mesh_terms: D002780:Cholestasis, Intrahepatic / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D018805:Sepsis / Q000150:complications*; D013203:Staphylococcal Infections / Q000150:complications*; D018746:Systemic Inflammatory Response Syndrome / Q000150:complications