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Unexpected clinical remission of cholestasis after rifampicin therapy in patients with normal or slightly increased levels of gamma-glutamyl transpeptidase.
[benign recurrent intrahepatic cholestasis]
Rifampicin
is
an
effective
drug
against
pruritus
in
intrahepatic
cholestasis
.
However
,
there
is
no
specific
hepatic
disease
in
which
its
use
could
cause
undoubtedly
biochemical
improvement
.
The
aim
of
this
study
was
to
describe
patients
with
complete
remission
of
cholestatic
symptoms
after
rifampicin
therapy
.
We
reported
three
female
patients
with
intrahepatic
cholestasis
with
no
evidence
of
viral
,
metabolic
,
or
autoimmune
liver
diseases
.
Total
bilirubin
levels
ranged
from
13
.
2
to
27
.
2
mg
/
dl
(
before
the
first
treatment
with
rifampicin
)
,
and
in
all
of
them
gamma-glutamyl
transpeptidase
values
were
within
the
normal
range
or
slightly
increased
.
Rifampicin
therapy
was
administered
orally
,
without
any
concomitant
drug
,
with
an
effective
dosage
of
5
-
17
mg
/
kg
/
day
.
In
all
patients
,
pruritus
ceased
completely
and
bilirubin
returned
to
normal
values
.
The
symptoms
recurred
after
rifampicin
withdrawal
on
,
at
least
,
three
occasions
in
each
patient
,
and
these
symptoms
were
always
eliminated
after
its
reintroduction
.
The
patients
had
a
total
of
16
cholestatic
episodes
during
a
follow-up
of
8
yr
,
with
a
complete
clinical
recovery
in
all
of
them
.
Undergoing
therapy
with
a
suitable
dosage
of
rifampicin
,
none
of
the
patients
had
a
cholestatic
crisis
even
during
a
period
for
as
long
as
12
months
.
The
diagnosis
of
two
patients
was
consistent
with
benign
recurrent
intrahepatic
cholestasis
,
and
it
was
not
well
defined
in
the
remaining
.
Rifampicin
may
induce
clinical
remission
,
and
perhaps
prevent
clinical
relapses
of
intrahepatic
cholestasis
with
normal
or
slightly
increased
levels
of
gamma-glutamyl
transpeptidase
.
Diseases
Validation
Diseases presenting
"increased levels of gamma-glutamyl transpeptidase"
symptom
benign recurrent intrahepatic cholestasis
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