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[Ursodeoxycholic acid treatment shortens the course of cholestasis in two patients with benign recurrent intrahepatic cholestasis].
[benign recurrent intrahepatic cholestasis]
Benign
recurrent
intrahepatic
cholestasis
(
BRIC
)
is
a
rare
autosomal-crecessive
or
sporadic
disorder
,
characterized
by
repeated
episodes
of
unexplained
cholestasis
followed
by
prolonged
asymptomatic
periods
.
We
present
two
male
patients
aged
12
and
15
years
old
who
initially
presented
cholestasis
and
who
had
no
family
history
of
liver
or
biliary
disease
.
Typically
,
alkaline
phosphatase
and
bilirubin
levels
were
elevated
,
with
a
slight
increase
in
transaminases
and
gamma-glutamyltransferase
.
In
both
patients
biliary
tract
disease
was
ruled
out
by
endoscopic
retrograde
cholangiopancreatography
and
magnetic
resonance
cholangiography
while
no
significant
abnormalities
of
the
liver
parenchyma
were
found
on
liver
biopsy
.
Early
treatment
with
ursodeoxycholic
acid
(
UDCA
)
reduced
the
duration
of
the
cholestasis
episode
compared
with
that
of
other
episodes
in
which
the
patient
had
received
other
treatment
or
the
treatment
was
late
(
1
or
2
months
vs
4
months
in
patient
1
and
1
-
3
months
vs
5
months
in
patient
2
,
respectively
)
.
Consensus
is
lacking
on
the
treatment
of
BRIC
although
several
treatment
have
been
used
.
UDCA
could
be
effective
in
increasing
bile
acid
secretion
and
in
reducing
serum
bilirubin
levels
.
In
the
two
patients
described
,
the
initial
dosage
was
15
mg
/
kg
/
day
,
which
was
subsequently
maintained
at
6
mg
/
kg
/
day
,
which
was
subsequently
maintained
6
mg
/
kg
/
day
until
biochemical
parameters
returned
to
normal
.
Nevertheless
,
larger
studies
are
required
to
confirm
that
UDA
shortens
episodes
of
cholestasis
in
BRIC
.
Diseases
Validation
Diseases presenting
"cholestasis"
symptom
benign recurrent intrahepatic cholestasis
carcinoma of the gallbladder
congenital toxoplasmosis
erythropoietic protoporphyria
familial mediterranean fever
megacystis-microcolon-intestinal hypoperistalsis syndrome
neonatal adrenoleukodystrophy
x-linked adrenoleukodystrophy
zellweger syndrome
This symptom has already been validated