Systemic Causes of Cholestasis

deLemos, Andrew S.

doi:10.1016/j.cld.2012.11.001

Cited by 38 publications

(31 citation statements)

References 76 publications

(70 reference statements)

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“…In each case, sepsis was considered an underlying cause of hyperbilirubinemia, although one of these dogs also had large intrahepatic choleliths and cholangitis. 12 Absence of hyperbilirubinemia and/or hypercholesterolemia in most DPM dogs correlates with the absence of histologic features consistent with obstructive or obliterative ductal disease or diffuse cholangitis.…”

Section: Discussionmentioning

confidence: 93%

Ductal Plate Malformation in the Liver of Boxer Dogs

et al. 2016

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Ductal plate malformations (DPMs) represent developmental biliary disorders with a wide phenotypic spectrum. This study characterizes DPM in 30 Boxer dogs. Median age was 1.5 (range, 0.3-10.0) years, with 12 dogs <1 year. Clinical features included increased serum levels of liver enzymes (28), gastrointestinal signs (16), poor body condition (14), abdominal effusion (9), and hepatic encephalopathy (2). Additional malformations included gallbladder atresia (8), atrophied left liver (2), absent quadrate lobe with leftdisplaced gallbladder (1), portal vasculature atresia (left liver, 1), intrahepatic portosystemic shunt (1), and complex intrahepatic arteriovenous malformation (1). All dogs had portal tracts dimensionally expanded by a moderate-to-severe multiple small bile duct phenotype embedded in abundant extracellular matrix; 80% displayed variable portal-to-portal bridging. Quantitative analysis confirmed significantly increased fibrillar collagen and a 3-fold increased portal tract area relative to 6 Boxer and 10 non-Boxer controls. Biliary phenotype was dominated by tightly formed CK19-positive ductules, typically 10 to 15 mm in diameter, with 3 to >30 profiles per portal tract, reduced luminal apertures, and negative Ki-67 immunoreactivity. CK19-positive biliary epithelium intersected directly with zone 1 hepatocytes as a signature feature when considered with other DPM characteristics. Phenotypic variation included a multiple small bile duct phenotype (all dogs), predominantly thin-walled sacculated ducts (4), well-formed saccular ducts (4), and sacculated segmental, interlobular, and intralobular ducts (Caroli malformation, 2 dogs, one with bridging portal fibrosis). Histologic evidence of portal venous hypoperfusion accompanied increased biliary profiles in every case. We propose that this spectrum of disorders be referred to as DPM with appropriate modifiers to characterize the unique phenotypes.

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Section: Discussionmentioning

confidence: 93%

Ductal Plate Malformation in the Liver of Boxer Dogs

et al. 2016

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“…Cholestasis is encountered in numerous hepatic and systemic disorders and is a particularly common feature of cirrhosis. Based on Dame Sheila Sherlock's initial observations of increased serum BAs in liver disease, further efforts in the 1970s established that up to a 100‐fold increase in concentrations is encountered in cirrhosis.…”

Section: Bile Acids and Their Metabolismmentioning

confidence: 99%

Bile acids and cardiovascular function in cirrhosis

Voiosu

Wiese

Voiosu

et al. 2017

Liver International

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“…Cholestasis in the hospitalized patient has a broad differential given the numerous potential systemic causes [ 1 ] …”

Section: Discussionmentioning

confidence: 99%

“…Solid organ and HSCT recipients are at risk for post-transplant lymphoproliferative disorder (PTLD) [ 153 , 154 ]. This Epstein-Barr virus associated type of non-Hodgkin lymphoma can involve the liver and can lead to either intrahepatic or extrahepatic (obstructive) cholestasis [ 1 ].…”

Section: Lymphomamentioning

confidence: 99%