title: New therapeutic option with N-acetylcysteine for primary sclerosing cholangitis: two case reports.
abstract: Primary sclerosing cholangitis is a progressive, cholestatic hepatic disease of unknown etiology. It is characterized by progressive inflammation, destruction, and fibrosis of the intrahepatic and extrahepatic bile ducts. Several medical therapies have been tried such as penicilamin, colchicine, methatraxate, cyclosporine, tacrolimus, and ursodeoxycholic acid. Treatment with mucolytic agents in excessively high viscosity conditions appears to have an important role. N-acetylcysteine (NAC), as a mucolytic agent, may fascilitate the drainage in partial obstructions by decreasing the mucous viscosity. We suggest that NAC and ursodeoxycholic acid have markedly positive effects on the clinical course of cholangitis and cholestasis when used together by affecting bile viscosity. Here, we present two cases treated with NAC. NAC capsul therapies at 800 mg/day were administered to two patients with primary sclerosing cholangitis. Clinical and laboratory parameters of patients saw significant improvement.
authors.affiliation: Department of Gastroenterology, Faculty of Medicine, Balcali Hospital, Cukurova University, Yuregir, Adana, Turkey. burhanozdil@gmail.com
authors.forename: Burhan
authors.initials: B
authors.lastname: Ozdil
authors.forename: Arif
authors.initials: A
authors.lastname: Cosar
authors.forename: Hikmet
authors.initials: H
authors.lastname: Akkiz
authors.forename: Macit
authors.initials: M
authors.lastname: Sandikci
authors.forename: Can
authors.initials: C
authors.lastname: Kece
mesh_terms: D000111:Acetylcysteine / Q000627:therapeutic use*; D000328:Adult; D002756:Cholagogues and Choleretics / Q000627:therapeutic use*; D015209:Cholangitis, Sclerosing / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D016166:Free Radical Scavengers / Q000627:therapeutic use*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008297:Male; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D002756:Cholagogues and Choleretics; D016166:Free Radical Scavengers; D014580:Ursodeoxycholic Acid; D000111:Acetylcysteine