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Benign recurrent intrahepatic cholestasis progressing to progressive familial intrahepatic cholestasis: low GGT cholestasis is a clinical continuum.
[benign recurrent intrahepatic cholestasis]
Benign
recurrent
intrahepatic
cholestasis
(
BRIC
)
is
an
autosomal
recessive
liver
disease
,
characterised
by
intermittent
attacks
of
cholestasis
,
which
can
start
at
any
age
and
last
for
several
weeks
to
months
.
Characteristically
serum
GGT
activity
is
low
and
normal
liver
structure
is
preserved
.
Progressive
familial
intrahepatic
cholestasis
(
PFIC
)
is
another
liver
disease
,
characterised
by
severe
cholestasis
,
starting
almost
invariably
before
6
months
of
age
.
All
patients
progress
to
cirrhosis
,
liver
failure
and
death
,
unless
a
liver
transplantation
is
performed
.
We
now
identified
four
patients
who
presented
in
childhood
with
recurrent
attacks
of
cholestasis
,
while
in
the
course
of
the
disease
the
cholestasis
gradually
became
permanent
.
Although
liver
biopsies
performed
in
the
early
stages
of
the
disease
showed
normal
liver
architecture
,
late
stage
biopsies
revealed
evident
fibrosis
with
porto
-portal
septa
formation
.
In
conclusion
,
the
disease
of
these
patients
started
with
the
clinical
and
histopathological
characteristics
of
BRIC
but
progressed
to
PFIC
.
Diseases
Validation
Diseases presenting
"late stage biopsies revealed evident fibrosis with porto-portal septa formation"
symptom
benign recurrent intrahepatic cholestasis
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