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Benign recurrent intrahepatic cholestasis associated with mutations of the bile salt export pump.
[benign recurrent intrahepatic cholestasis]
A
young
patient
with
recurrent
attacks
of
intrahepatic
cholestasis
is
described
.
On
the
basis
of
clinical
presentation
,
laboratory
findings
and
genetic
analysis
,
the
diagnosis
of
benign
recurrent
intrahepatic
cholestasis
type
2
(
BRIC
-
2
)
was
established
.
By
the
use
of
BSEP-
specific
antibodies
,
almost
complete
absence
of
BSEP
from
the
canalicular
membrane
of
liver
cells
was
detected
in
the
patient
.
Two
different
BSEP
mutations
were
found
.
One
mutation
(
E
186
G
)
had
been
described
in
one
BRIC
-
2
case
;
the
second
mutation
(
V
444
A
)
is
more
frequent
and
has
been
linked
to
intrahepatic
cholestasis
of
pregnancy
.
It
is
concluded
that
this
form
of
compound
heterozygosity
of
the
BSEP
gene
reduces
the
amount
of
BSEP
protein
due
to
protein
instability
or
mis-targeting
,
which
is
the
underlying
reason
for
reduced
bile
salt
excretion
and
cholemia
.
Diseases
Validation
Diseases presenting
"intrahepatic cholestasis"
symptom
benign recurrent intrahepatic cholestasis
zellweger syndrome
This symptom has already been validated