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Progressive familial intrahepatic cholestasis.
[benign recurrent intrahepatic cholestasis]
Progressive
familial
intrahepatic
cholestasis
(
PFIC
)
is
a
heterogeneous
group
of
autosomal
recessive
childhood
cholestasis
of
hepatocellular
origin
.
PFIC
1
,
also
known
as
Byler
disease
,
was
first
described
in
Amish
kindred
.
It
is
characterized
by
cholestasis
often
arising
in
the
neonatal
period
and
it
leads
to
death
due
to
liver
failure
.
PFIC
1
,
like
Benign
Recurrent
Intrahepatic
Cholestasis
(
BRIC
)
which
is
the
benign
form
of
the
same
disease
,
recognizes
mutations
in
the
ATP
8
B
1
gene
.
PFIC
2
disease
is
clinically
similar
to
PFIC
1
but
it
has
a
different
gene
mutation
causing
a
defect
in
the
Bile
Salt
Export
Pump
(
BSEP
)
,
exclusively
expressed
in
the
liver
and
involved
in
the
canalicular
secretion
of
bile
acids
.
PFIC
3
usually
appears
later
in
life
and
it
has
a
higher
risk
of
portal
hypertension
,
gastrointestinal
bleeding
and
liver
failure
.
This
particular
form
of
disease
(
the
only
one
with
high
serum
values
of
g-glutamil
transpeptidase
)
,
is
associated
to
a
genetic
defect
in
the
class
III
multidrug
resistance
protein
(
MDR
)
.
External
biliary
diversion
and
ursodeoxycholic
acid
therapy
,
should
be
considered
as
the
initial
therapy
in
these
patients
,
even
if
liver
transplantation
still
seems
to
be
the
only
solution
for
most
patients
.
Diseases
Validation
Diseases presenting
"it leads to death due to liver failure"
symptom
benign recurrent intrahepatic cholestasis
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