Cholestatic liver disease associated with diphenylhydantoin therapy - Possible pathogenic importance of altered bile salt metabolism

Campbell C.B., McGuffie C., Weedon A.P. and Powell L.W. (1977) Cholestatic liver disease associated with diphenylhydantoin therapy - Possible pathogenic importance of altered bile salt metabolism. The American Journal of Digestive Diseases, 22 3: 255-262. doi:10.1007/BF01072286


Author Campbell C.B.
McGuffie C.
Weedon A.P.
Powell L.W.
Title Cholestatic liver disease associated with diphenylhydantoin therapy - Possible pathogenic importance of altered bile salt metabolism
Journal name The American Journal of Digestive Diseases   Check publisher's open access policy
ISSN 1573-2568
Publication date 1977-01-01
Sub-type Article (original research)
DOI 10.1007/BF01072286
Volume 22
Issue 3
Start page 255
End page 262
Total pages 8
Publisher Kluwer Academic Publishers-Plenum Publishers
Subject 2715 Gastroenterology
2700 Medicine
Abstract A ten-year-old boy presented with a prolonged cholestatic liver disease 5 weeks after starting diphenylhydantoin therapy. The initial phase of his illness was characterized by hepatocellular damage with swollen liver cells and centrilobular cholestasis. Severe hyperlipoproteinemia with eruptive xanthomata developed within 3 weeks of his initial jaundice. The second phase of his illness was characterized by portal tract inflammation with bile ductular proliferation and chronic cholestasis gradually resolving over a period of 15 months. It is postulated that diphenylhydantoin sensitivity produced swollen hepatocytes with hypertrophy of the smooth endoplasmic reticulum, reducing hepatic sinusoidal blood flow and the clearance of secondary bile salts. A fall in clearance of lipoproteins, including the cholesterol precursor of primary bile acid synthesis, may have been responsible for a reduction in serum bile acid concentration. High levels of serum lithocholic acid, largely unsulfated presumably due to decreased hepatic uptake, may have produced the prolonged second phase of this illness when histological changes resembled that seen in experimental animals following lithocholic acid administration.
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Unknown

Document type: Journal Article
Sub-type: Article (original research)
Collection: Scopus Import - Archived
 
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Created: Tue, 16 Aug 2016, 13:11:03 EST by System User