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Drug-induced cholestasis.

H J Zimmerman, J H Lewis

    Medical Toxicology
    |March 1, 1987
    PubMed
    Summary
    This summary is machine-generated.

    Intrahepatic cholestasis, or arrested bile flow, results from liver cell or bile duct injuries. Drug-induced liver injury is a common cause, leading to various clinical symptoms and potential chronic forms.

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    Area of Science:

    • Hepatology
    • Gastroenterology
    • Toxicology

    Background:

    • Intrahepatic cholestasis is characterized by impaired bile flow within the liver.
    • It presents with biochemical, clinical, and morphological features similar to extrahepatic obstruction.
    • Causes include hepatocyte lesions (canalicular, hepatocanalicular, hepatocellular) and ductal lesions.

    Purpose of the Study:

    • To elucidate the mechanisms and sites of injury in intrahepatic cholestasis.
    • To review the causes, particularly drug-induced cholestasis.
    • To describe the clinical manifestations and variations in drug-induced liver injury.

    Main Methods:

    • Review of literature on intrahepatic cholestasis and drug-induced liver injury.
    • Analysis of mechanisms involving bile acid-dependent and independent flow.

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  • Identification of cellular and subcellular sites of damage.

    • Main Results:

    • Defective bile flow can stem from impaired bile acid transport, altered canalicular function, or ductal injury.
    • Key sites of injury include plasma membranes, tight junctions, and the pericanalicular network.
    • Various drugs and chemical agents can induce cholestasis through distinct injury pathways.

    Conclusions:

    • Intrahepatic cholestasis arises from complex defects in bile formation and transport.
    • Drug-induced cholestasis is a significant clinical entity, presenting acutely or chronically.
    • Understanding the sites of injury is crucial for diagnosing and managing cholestatic liver diseases.