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Progressive familial intrahepatic cholestasis type 1.
[benign recurrent intrahepatic cholestasis]
Progressive
familial
intrahepatic
cholestasis
type
1
is
a
rare
genetic
liver
disease
that
presents
in
the
first
year
of
life
.
Bile
salts
are
elevated
and
these
patients
are
often
jaundiced
.
Despite
the
cholestasis
,
serum
gamma-glutamyltransferase
activity
is
normal
or
reduced
.
Pruritus
is
a
major
symptom
in
these
patients
.
Partial
external
biliary
diversion
is
helpful
in
several
patients
as
it
reduces
the
pruritus
and
postpones
or
even
avoids
liver
transplantation
.
The
disease
is
caused
by
mutations
in
the
gene
ATP
8
B
1
that
preclude
the
normal
expression
of
ATP
8
B
1
.
ATP
8
B
1
is
a
protein
that
acts
as
a
lipid
flippase
,
transporting
phosphatidylserine
from
the
exoplasmic
to
the
cytoplasmic
leaflet
of
the
canalicular
membrane
of
hepatocytes
.
The
authors
have
shown
that
the
canalicular
membrane
of
ATP
8
B
1
-
deficient
hepatocytes
is
less
stable
as
evidenced
by
enhanced
extraction
of
membrane
constituents
by
bile
salts
.
Recent
evidence
suggests
membrane
instability
in
ATP
8
B
1
-
deficient
hair
cells
of
the
ear
,
providing
an
explanation
for
hearing
loss
in
ATP
8
B
1
deficiency
.
Although
the
exact
etiology
of
cholestasis
is
incompletely
understood
,
it
is
hypothesized
that
ATP
8
B
1
deficiency
results
in
enhanced
cholesterol
extraction
from
the
canalicular
membrane
,
which
impairs
the
function
of
the
bile
salt
export
pump
(
BSEP
)
,
resulting
in
cholestasis
.
Mutations
in
ATP
8
B
1
also
cause
benign
recurrent
intrahepatic
cholestasis
,
a
milder
variant
of
the
disease
characterized
by
episodes
of
cholestasis
.
The
onset
and
resolution
of
the
cholestatic
episodes
in
these
patients
is
still
not
well
understood
.
Diseases
Validation
Diseases presenting
"first year"
symptom
22q11.2 deletion syndrome
achondroplasia
alpha-thalassemia
aniridia
benign recurrent intrahepatic cholestasis
child syndrome
cohen syndrome
congenital adrenal hyperplasia
congenital diaphragmatic hernia
congenital toxoplasmosis
cowden syndrome
dystrophic epidermolysis bullosa
epidermolysis bullosa simplex
erythropoietic protoporphyria
gm1 gangliosidosis
hirschsprung disease
homocystinuria without methylmalonic aciduria
junctional epidermolysis bullosa
kabuki syndrome
kindler syndrome
krabbe disease
lymphangioleiomyomatosis
megacystis-microcolon-intestinal hypoperistalsis syndrome
neonatal adrenoleukodystrophy
phenylketonuria
pleomorphic liposarcoma
pyruvate dehydrogenase deficiency
severe combined immunodeficiency
sneddon syndrome
waldenström macroglobulinemia
wolf-hirschhorn syndrome
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