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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
"deficient hepatocytes"
symptom
benign recurrent intrahepatic cholestasis
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