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Benign recurrent intrahepatic cholestasis: late initial diagnosis in adulthood.
[benign recurrent intrahepatic cholestasis]
Benign
recurrent
intrahepatic
cholestasis
(
BRIC
)
is
a
rare
autosomal
recessive
or
sporadic
disorder
,
characterized
by
recurrent
episodes
of
intense
pruritus
and
jaundice
that
resolve
spontaneously
without
leaving
considerable
liver
damage
.
The
attacks
can
start
at
any
age
,
but
the
first
attack
is
usually
seen
before
the
second
decade
of
life
.
We
report
the
case
of
a
young
adult
male
patient
with
BRIC
who
presented
with
recurrent
cholestatic
jaundice
and
pruritus
with
negative
work
up
for
all
possible
etiologies
and
a
liver
biopsy
consistent
with
intrahepatic
cholestasis
.
He
improved
on
treatment
with
rifampicin
and
has
not
suffered
another
attack
on
follow
up
.
Although
in
adulthood
,
BRIC
diagnosis
should
be
kept
in
mind
in
patients
with
recurrent
cholestatic
attacks
with
symptom
free
intervals
after
main
bile
duct
obstruction
and
other
congenital
or
acquired
causes
of
intrahepatic
cholestasis
excluded
.
Diseases
Validation
Diseases presenting
"pruritus with negative work up for all possible etiologies and a liver biopsy consistent with intrahepatic cholestasis"
symptom
benign recurrent intrahepatic cholestasis
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