Intrahepatic cholestasis in common chronic liver diseases
Article first published online: 8 AUG 2013
© 2013 Stichting European Society for Clinical Investigation Journal Foundation. Published by John Wiley & Sons Ltd
European Journal of Clinical Investigation
Volume 43, Issue 10, pages 1069–1083, October 2013
How to Cite
Eur J Clin Invest 2013; 43 (10): 1069–1083
- Issue published online: 18 SEP 2013
- Article first published online: 8 AUG 2013
- Accepted manuscript online: 20 JUN 2013 08:19AM EST
- Manuscript Accepted: 15 JUN 2013
- Manuscript Received: 12 MAR 2013
- Alcoholic liver disease;
- drug-induced cholestasis;
- fatty liver disease;
- viral hepatitis
Background and objective
Cholestasis represents the consequence of impaired bile formation and decrease in bile flow, generally classified as extra- and intrahepatic. Cholestasis is the pivotal hallmark of the so-called primary cholestatic liver diseases but may also emerge in other forms of chronic liver injury. The aim now was to summarise the current state of knowledge on intrahepatic cholestasis related to chronic liver diseases.
For this overview on intrahepatic cholestasis in chronic liver disorders other than the ‘classic’ cholestatic liver diseases, selected references were retrieved by literature search in MEDLINE and textbooks were reviewed. All articles were selected that discussed pathophysiological and clinical aspects of intrahepatic cholestasis in the context of alcoholic liver disease, nonalcoholic fatty liver disease, chronic hepatitis B and C virus infections as well as drug-induced and granulomatous liver diseases. Titles referring to primary biliary cirrhosis and sclerosing cholangitis were excluded.
Results and conclusions
Dependent on the aetiology, intrahepatic cholestasis is present at variable frequencies and in different disease stages in chronic liver diseases. Cholestasis secondary to chronic liver injury may denote a severe disease course and development of end-stage liver disease or specific disease variants. These findings indicate that ‘secondary intrahepatic cholestasis’ (SIC) can occur in the natural course of chronic liver diseases other than the primary cholestatic diseases, in particular in the setting of advanced disease progression.