Cholangitis Lenta: What Hepatologists Need to Know

Booth, Adam L.; Merwat, Shehzad; Merwat, Sheharyar; Stevenson, Heather L.

doi:10.1002/cld.907

Cited by 3 publications

(1 citation statement)

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“…There was also marked hepatocellular and canalicular cholestasis predominantly in zones 3 and 2, as well as prominent ductular reaction periportally (zone 1) accompanied by the presence of bile concretions in the lumen of dilated cholangioles. This feature referred as cholangiolar cholestasis or cholangitis lenta, although not entirely specific, it raises high suspicion of sepsis [14]. On the other hand, the pattern of steatosis implied a toxic liver injury similar to the one observed after parenteral administration of tetracycline.…”

Section: Case Presentationmentioning

confidence: 96%

Tigecycline induced liver toxicity in a renal transplant recipient with hepatic histology imitating sepsis

Sakellariou

2023

Open J Clin Med Case Rep

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Section: Case Presentationmentioning

confidence: 96%

Tigecycline induced liver toxicity in a renal transplant recipient with hepatic histology imitating sepsis

Sakellariou

2023

Open J Clin Med Case Rep

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Role of bile acids and their receptors in gastrointestinal and hepatic pathophysiology

Fuchs

Trauner

2022

Nat Rev Gastroenterol Hepatol

202

126

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Liver Histology in Septic Patients: Is It All About Ductular Cholestasis?

Bsirini

Katerji

Lee

et al. 2022

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Cholestasis within bile ductules is touted as a key histologic finding in septic patients but is not entirely sensitive or specific. The spectrum of other histopathologic findings in septic patients has not been thoroughly studied. Objective.— To evaluate histologic features in liver biopsies from septic patients, as well as mimics. Design.— For 121 liver samples where sepsis was mentioned in provided clinical information or in the pathologic differential diagnosis, we compiled patient outcome, clinical impression (sepsis or not), and blood culture results. We evaluated each case for inflammatory and cholestatic histologic findings, comparing them between patients with and without clinical sepsis, and between patients with gram-positive versus gram-negative results on blood culture. Results.— Cases from clinically septic patients (n = 77) showed portal mononuclear inflammation (52 cases, 68%), lobular neutrophilic inflammation (45, 58%), ductular reaction (58, 75%), lobular cholestasis (68, 88%), ductular cholestasis (52, 68%), and acidophil bodies (36, 47%). Findings between clinically septic and nonseptic patients were similar, though the latter more often had lobular mononuclear inflammation (19% versus 45%, P = .004). Ductular cholestasis rates were similar in both groups (68% versus 55%, P = .17). Ductular cholestasis had a sensitivity of 68%, a specificity of 45%, a positive predictive value of 68%, and an accuracy of 60% for the diagnosis of sepsis. Gram-positive and gram-negative sepsis caused comparable findings. Conclusions.— Ductular cholestasis can be present in septic and nonseptic liver samples, though its presence does suggest the possibility of sepsis. Other common findings in sepsis include lobular cholestasis, ductular reaction, portal mononuclear inflammation, and lobular neutrophilic inflammation.

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Cholangitis Lenta: What Hepatologists Need to Know

Cited by 3 publications

References 10 publications

Tigecycline induced liver toxicity in a renal transplant recipient with hepatic histology imitating sepsis

Tigecycline induced liver toxicity in a renal transplant recipient with hepatic histology imitating sepsis

Role of bile acids and their receptors in gastrointestinal and hepatic pathophysiology

Liver Histology in Septic Patients: Is It All About Ductular Cholestasis?

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