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[Benign recurrent intrahepatic cholestasis].
[benign recurrent intrahepatic cholestasis]
When
aged
25
years
,
a
now
38
-
year
-old
man
had
acute
hepatitis
A
with
jaundice
.
In
the
subsequent
years
he
had
recurrent
jaundice
with
severe
itching
and
insomnia
.
Multiple
hospital
admissions
with
laparoscopy
and
liver
biopsy
failed
to
find
a
cause
.
On
admission
he
was
again
jaundiced
,
but
there
was
a
discrepancy
(
as
on
previous
examinations
)
between
the
degree
of
jaundice
and
the
good
general
condition
.
The
liver
was
only
slightly
enlarged
to
palpation
,
the
spleen
was
just
palpable
below
the
costal
margin
.
Bilirubin
concentration
was
50
.
4
mg
/
dl
(
direct
bilirubin
14
mg
/
dl
)
,
alkaline
phosphatase
1027
U
/
l
,
GOT
and
GPT
activities
were
only
slightly
increased
.
Ultrasound
of
the
upper
abdomen
showed
deformation
of
the
middle
and
small
-calibre
portal
vein
branches
and
echo
-rich
,
ribbon-shaped
coverings
.
Electronmicroscopy
of
a
liver
biopsy
also
revealed
moderate
hepatic
fibrosis
,
indicating
benign
recurrent
intrahepatic
cholestasis
.
Ursodeoxycholic
acid
was
administered
(
250
mg
two
to
three
times
daily
by
mouth
)
,
glycerol
trinitrate
(
0
.
8
mg
six
times
daily
by
mouth
)
,
colestyramine
(
4
g
up
to
five
times
daily
by
mouth
)
,
and
flunitrazepam
(
0
.
5
-
1
mg
orally
at
night
)
.
There
was
only
slight
improvement
,
but
the
liver
function
parameters
became
normal
after
three
months
.
There
has
been
no
recurrence
after
4
years
.
Diseases
Validation
Diseases presenting
"but the liver function parameters became normal after three months"
symptom
benign recurrent intrahepatic cholestasis
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