title: [Progress in diagnosis and therapy of extrahepatic manifestations of cholestatic liver diseases].
abstract: Extra-hepatic complications of cholestasis mainly include pruritus, fatigue and metabolic bone diseases, and their molecular mechanisms have not yet been fully identified so far. Though therapeutic regimens targeted at the pathogenesis alleviate the symptoms temporarily, the therapeutic effects are limited, and therefore expounding the pathogenesis will help find more appropriate therapeutic approaches. Pruritus may be caused by nerve conduction block resulting from accumulation of some substances in the accumulated bile, existing recommended methods like drug therapy with cholestyramine and blood purification can markedly alleviate cholestasis-induced pruritus. Fatigue may be a consequence of the central nervous system disorders, and there is currently no specific therapy. Metabolic bone diseases (MBD), also known as hepatic osteodystrophy, are often manifested by osteopenia and osteoporosis, and correcting bad factors responsible for bone loss will help relieve MBD. Bisphosphonate is recommended for treatment of cholestasis-induced osteoporosis. In the event that a patient experiences intolerable pruritus and frequent fractures resulting from osteoporosis, assessment for liver transplantation should be conducted.
authors: Department of Gastroenterology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China.
authors: L G
authors: LG
authors: Lu
mesh_terms: D001851:Bone Diseases, Metabolic / Q000188:drug therapy / Q000209:etiology*; D015209:Cholangitis, Sclerosing / Q000150:complications; D002779:Cholestasis / Q000150:complications*; D005221:Fatigue / Q000209:etiology*; D006801:Humans; D008107:Liver Diseases; D016031:Liver Transplantation; D010024:Osteoporosis; D011537:Pruritus / Q000209:etiology*