TEMPORARY RESOLUTION OF OBSTRUCTIVE-JAUNDICE DURING URSODEOXYCHOLIC ACID THERAPY IN A PATIENT WITH PRIMARY SCLEROSING CHOLANGITIS AND A DOMINANT BILIARY STRICTURE

Citation
M. Fracchia et al., TEMPORARY RESOLUTION OF OBSTRUCTIVE-JAUNDICE DURING URSODEOXYCHOLIC ACID THERAPY IN A PATIENT WITH PRIMARY SCLEROSING CHOLANGITIS AND A DOMINANT BILIARY STRICTURE, The Italian Journal of Gastroenterology, 27(8), 1995, pp. 430-435
Citations number
38
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Gastroenterology & Hepatology
ISSN journal
0392-0623
Volume
27
Issue
8
Year of publication
1995
Pages
430 - 435
Database
ISI
SICI code
0392-0623(1995)27:8<430:TROODU>2.0.ZU;2-1
Abstract
Obstructive dominant biliary strictures are considered irreversible le sions in patients with primary sclerosing cholangitis; therapy with ur sodeoxycholic acid has been shown to determine clinical, biochemical a nd histological improvement in such patients. To date, two reports of anatomical improvement of biliary tract lesions during ursodeoxycholic acid therapy have been published. We observed a 19-year-old male pati ent with primary sclerosing cholangitis who presented with severe chol estasis due to an obstructive dominant stricture of the common hepatic duct and absence of biliary excretion at cholescintigraphy. Oral admi nistration of 900 mg/day ursodeoxycholic acid was followed by rapid de crease of jaundice and a normalization of life activity. Twelve months later a repeat cholescintigraphy showed normal biliary excretion, Des pite continuing therapy, two years later the patient needed liver tran splantation because of recurring severe obstructive Jaundice. This rep ort suggests that ursodeoxycholic acid may reverse a severe cholestati c syndrome in the course of primary sclerosing cholangitis despite a d ominant stricture in the biliary tree. The mechanisms responsible for this effect are still obscure, but may involve restoration of bile flo w through the biliary stricture. The late relapse during continuing th erapy suggests that - at least in some patients - these effects may be temporary and ursodeoxycholic acid may lose its efficacy in the long term.