Sclerosing Cholangitis from Intraarterial Floxuridine

Dikengil, Asim; Siskind, Barry N.; Morse, Steven S.; Swedlund, Anne; Bober-Sorcinelli, Kathleen E.; Burrell, Morton I.; Margulis, Alexander R.

doi:10.1097/00004836-198612000-00022

Cited by 28 publications

(7 citation statements)

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“…170,193,[246][247][248][249][250][251][252][253][254][255][256] Sclerosing cholangitislike changes on imaging have been described with chemotherapeutic agents such as 5-fluorodeoxyuridine after hepatic intra-arterial infusions for treatment of hepatic metas- tases. 249,[254][255][256] Cholangiopathy is well documented after abuse of ketamine, both small duct changes and cholangiographic abnormalities. 246,247,256 Secondary sclerosing cholangitis associated with other drugs such as methimazole and docetaxelinduced secondary sclerosing cholangitis have also been reported.…”

Section: Imagingmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Drug-induced liver injury

Andrade¹,

Aithal²,

Bjõrnsson³

et al. 2019

Journal of Hepatology

750

394

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Idiosyncratic (unpredictable) drug-induced liver injury is one of the most challenging liver disorders faced by hepatologists, because of the myriad of drugs used in clinical practice, available herbs and dietary supplements with hepatotoxic potential, the ability of the condition to present with a variety of clinical and pathological phenotypes and the current absence of specific biomarkers. This makes the diagnosis of drug-induced liver injury an uncertain process, requiring a high degree of awareness of the condition and the careful exclusion of alternative aetiologies of liver disease. Idiosyncratic hepatotoxicity can be severe, leading to a particularly serious variety of acute liver failure for which no effective therapy has yet been developed. These Clinical Practice Guidelines summarize the available evidence on risk factors, diagnosis, management and risk minimization strategies for drug-induced liver jury.

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Section: Imagingmentioning

confidence: 99%

EASL Clinical Practice Guidelines: Drug-induced liver injury

Andrade¹,

Aithal²,

Bjõrnsson³

et al. 2019

Journal of Hepatology

750

394

View full text Add to dashboard Cite

show abstract

“…Clinically significant bile duct damage occurs in 5 to 20% of patients treated with hepatic arterial chemotherapy whatever the chemotherapeutic agent used, whether it is administered alone 20,24,[26][27][28][29] or in combination with iodized oil and/or gelatin sponge particles. [30][31][32][33] In a recent review, biliary strictures were found in 28 (8%) of 348 patients treated with HA artery infusion versus only 2 (0.7%) of their 276 controls.…”

Section: Etiologymentioning

confidence: 99%

Ischemic Cholangiopathy

Deltenre¹,

Valla²

2008

Semin Liver Dis

109

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Bile ducts are supplied with blood exclusively via hepatic arteries. Obstruction of large arteries is rapidly compensated for by the opening of preexisting intrahepatic or transcapsular collateral arteries, which prevents ischemic damage. Ischemic bile duct injury may occur when small hepatic arteries or the peribiliary vascular plexus are injured, or when all possible arterial blood supplies are interrupted, as is the case in transplanted liver with hepatic artery thrombosis. Most causes of bile duct ischemia are iatrogenic. Systemic diseases involving small hepatic arteries may also be implicated. Depending on the extent and velocity of the arterial obstructive process, ischemic cholangiopathy may present as acute formation of biliary casts, bile duct necrosis, or chronic disease resembling primary sclerosing cholangitis. In many patients, correction of arterial obstruction is not possible. When biliary drainage or reconstruction is not possible or has failed, liver transplantation is the only means of providing potential cure.

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“…Clinically significant bile duct damage occurs in 5-20% of patients treated with hepatic arterial chemotherapy whatever the chemotherapeutic agent used, whether it is administered alone [7,8,[62][63][64][65], or in combination with iodized oil and/or gelatin sponge particles [53,[66][67][68]. As shown in Table 1, biliary strictures were observed in 28 (8%) out of 348 patients treated with HA artery infusion, vs. only 2 (0.7%) of their 276 controls [51,[69][70][71][72][73].…”

Section: Hepatic Arterial Infusion Of Toxic Agentsmentioning

confidence: 99%