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[Classic case of benign recurrent intrahepatic cholestasis (Summerskill-Halshe-Tygstrup syndrome)].
[benign recurrent intrahepatic cholestasis]
The
benign
recurrent
intrahepatic
cholestasis
is
an
autosomal
recessively
inherited
liver
disease
.
The
gene
was
mapped
to
a
region
on
chromosome
18
q
21
-
22
.
Because
of
its
rareness
this
disease
is
first
considered
in
the
differential
diagnosis
of
cholestasis
after
many
years
of
extensive
investigations
.
We
report
about
a
17
-
year
-old
patient
,
who
suffered
from
intermittent
attacks
of
cholestatic
jaundice
and
pruritus
.
Clinical
course
,
laboratory
data
and
invasive
investigations
led
to
the
diagnosis
of
a
typical
case
of
benign
recurrent
intrahepatic
cholestasis
(
Summerskill-
Walshe-
Tygstrup
syndrome
)
.
This
disease
is
remarkable
for
a
discrepancy
between
a
rise
of
serum
bile
acids
at
the
onset
of
each
attack
and
a
later
rise
of
bilirubin
.
Typically
high
bilirubin
levels
are
noted
,
and
bilirubin
can
even
reach
more
than
50
mg
/
dl
.
The
serum
alkaline
phosphatase
is
increased
,
too
,
whereas
the
values
for
the
transaminases
and
gamma
GT
are
normal
or
only
slightly
elevated
.
Histological
studies
reveal
a
cholestasis
,
bile
plugs
in
the
bile
canaliculi
,
a
perilobular
fibrosis
and
inflammatory
infiltrations
of
the
periportal
zones
.
Differential
diagnosis
includes
an
abundance
of
diseases
with
cholestasis
.
Treatment
is
difficult
,
purely
symptomatic
and
often
without
marked
effect
.
Nevertheless
prognosis
is
good
,
histories
of
about
50
years
were
without
evidence
of
progression
to
cirrhosis
.
Diseases
Validation
Diseases presenting
"recessively inherited liver disease"
symptom
benign recurrent intrahepatic cholestasis
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