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Intractable cough and abnormal pulmonary function in benign recurrent intrahepatic cholestasis
R Chatila1, N V Bergasa, S Lagarde
1Department of Internal Medicine, Yale University, New Haven, Connecticut, USA.
The American Journal of Gastroenterology
|October 1, 1996
Summary
Benign recurrent intrahepatic cholestasis (BRIC) can cause severe, intractable cough during cholestatic episodes. This study suggests a link between cholestasis and cough, potentially due to circulating substances or vagus nerve stimulation.
Area of Science:
- Hepatology
- Pulmonology
- Gastroenterology
Background:
- Benign recurrent intrahepatic cholestasis (BRIC) is a rare liver disorder characterized by recurring episodes of cholestasis and intense itching.
- The unpredictable nature of BRIC episodes and their varied durations present diagnostic and management challenges.
Observation:
- A patient with BRIC experienced a severe, intractable cough during a cholestatic episode, coinciding with significant pruritus.
- Pulmonary function tests revealed mild restrictive abnormalities during the cholestatic episode, which resolved as the cholestasis subsided.
Findings:
- No other cause for the patient's cough was identified, suggesting a potential complication of cholestasis.
- The study proposes that circulating cholestatic substances may directly stimulate airway nerves or that vagus nerve stimulation secondary to liver dysfunction could trigger cough.
Implications:
- This case highlights an unrecognized complication of cholestasis, suggesting cough may be a symptom of BRIC.
- Further research into the mechanisms linking cholestasis and cough could lead to improved diagnostic approaches and therapeutic strategies for BRIC patients.