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Bile Duct Ligation in Mice: Induction of Inflammatory Liver Injury and Fibrosis by Obstructive Cholestasis

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Primary bile acid malabsorption. Histologic and immunologic study in three patients.

O S Popović, K M Kostić, V B Milović

Gastroenterology

|June 1, 1987

Summary

Chronic watery diarrhea in three patients was linked to bile acid malabsorption. Ileal biopsies revealed abnormalities, suggesting an immune basis for this condition, termed primary bile acid malabsorption.

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Ileectomy-induced Bile Overaccumulation in Mouse Intestine

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Published on: August 21, 2017

Area of Science:

Gastroenterology
Immunology
Pathology

Background:

Chronic watery diarrhea can stem from bile acid malabsorption (BAM).
Distinguishing primary BAM from other ileal disorders is crucial for effective treatment.
BAM's potential immune basis requires further investigation.

Purpose of the Study:

To investigate the underlying causes of chronic watery diarrhea in patients with confirmed BAM.
To characterize the ileal pathology and immune status in these patients.
To propose a classification for this specific type of BAM.

Main Methods:

Utilized tauro-23[75Se]selena-25 homocholic acid test for BAM diagnosis.
Performed retrograde ileoscopy with biopsies of the terminal ileum.
Assessed fecal fat, Schilling tests, barium studies, and immune function markers (autoantibodies, immune complexes, complement levels).

Main Results:

Patients responded definitively to cholestyramine therapy.
Standard tests for malabsorption (fecal fat, Schilling, barium) were normal.
Ileal biopsies showed crypt hyperplastic villous atrophy and colonic metaplasia with inflammation.
Abnormal immune function was observed, including autoantibodies, immune complexes, and hypocomplementemia.

Conclusions:

Identified a distinct entity of primary bile acid malabsorption potentially mediated by immune dysfunction.
Highlighted characteristic ileal histopathology in these patients.
Advocated for classifying this condition separately from other ileal disorders.