Intrahepatic cholestasis in common chronic liver diseases.
OBJECTIVE
Cholestasis represents the consequence of impaired bile formation and decrease in bile flow, generally classified as extra- and intrahepatic. Cholestasis is the pivotal hallmark of the so-called primary cholestatic liver diseases but may also emerge in other forms of chronic liver injury. The aim now was to summarise the current state of knowledge on intrahepatic cholestasis related to chronic liver diseases.


METHODS
For this overview on intrahepatic cholestasis in chronic liver disorders other than the 'classic' cholestatic liver diseases, selected references were retrieved by literature search in MEDLINE and textbooks were reviewed. All articles were selected that discussed pathophysiological and clinical aspects of intrahepatic cholestasis in the context of alcoholic liver disease, nonalcoholic fatty liver disease, chronic hepatitis B and C virus infections as well as drug-induced and granulomatous liver diseases. Titles referring to primary biliary cirrhosis and sclerosing cholangitis were excluded.


CONCLUSIONS
Dependent on the aetiology, intrahepatic cholestasis is present at variable frequencies and in different disease stages in chronic liver diseases. Cholestasis secondary to chronic liver injury may denote a severe disease course and development of end-stage liver disease or specific disease variants. These findings indicate that 'secondary intrahepatic cholestasis' (SIC) can occur in the natural course of chronic liver diseases other than the primary cholestatic diseases, in particular in the setting of advanced disease progression.
Department of Medicine II, Saarland University Medical Center, Homburg, Germany.
Christoph
C
Jüngst
Thomas
T
Berg
Jun
J
Cheng
Richard M
RM
Green
Jidong
J
Jia
Andrew L
AL
Mason
Frank
F
Lammert
D002780:Cholestasis, Intrahepatic / Q000139:chemically induced / Q000209:etiology*; D002908:Chronic Disease; D005234:Fatty Liver / Q000150:complications*; D006099:Granuloma / Q000150:complications*; D006505:Hepatitis / Q000150:complications*; D006525:Hepatitis, Viral, Human / Q000150:complications; D006801:Humans; D008108:Liver Diseases, Alcoholic / Q000150:complications*; D065626:Non-alcoholic Fatty Liver Disease
Alcoholic liver disease; bile; drug-induced cholestasis; fatty liver disease; viral hepatitis