Cholestatic hepatitis

Cholestatic Hepatitis is a medical condition characterized by the impairment or stoppage of bile flow, which leads to inflammation of the liver, or hepatitis. This condition can be caused by various factors, including certain medications, bile duct obstruction, and diseases affecting the liver. Cholestatic hepatitis is a significant health concern due to its potential to cause liver damage if not properly managed.

Causes

Cholestatic hepatitis can be triggered by several factors, which are broadly classified into intrahepatic (originating within the liver) and extrahepatic (originating outside the liver) causes.

• Intrahepatic causes include drug-induced liver injury, genetic disorders like Progressive Familial Intrahepatic Cholestasis, and autoimmune diseases such as Primary Biliary Cholangitis and Primary Sclerosing Cholangitis.
• Extrahepatic causes are often related to obstruction of the bile ducts, which can be due to gallstones, tumors, or strictures.

Symptoms

The symptoms of cholestatic hepatitis can vary depending on the underlying cause and severity of the condition. Common symptoms include:

• Jaundice (yellowing of the skin and eyes)
• Itching (pruritus)
• Dark urine
• Pale stool
• Fatigue
• Abdominal pain

Diagnosis

Diagnosis of cholestatic hepatitis involves a combination of clinical evaluation, laboratory tests, and imaging studies. Laboratory tests typically show elevated levels of bilirubin and alkaline phosphatase, indicative of bile flow obstruction. Imaging studies such as ultrasound, CT scan, or MRI may be used to visualize the bile ducts and identify any obstructions.

Treatment

Treatment of cholestatic hepatitis focuses on addressing the underlying cause of the condition. This may involve:

• Medications to treat specific causes, such as ursodeoxycholic acid for primary biliary cholangitis
• Procedures to remove bile duct obstructions, such as endoscopic retrograde cholangiopancreatography (ERCP)
• Liver transplantation in cases where the liver has been severely damaged

Prognosis

The prognosis for individuals with cholestatic hepatitis varies widely and depends on the underlying cause, the extent of liver damage, and the effectiveness of treatment. Early diagnosis and appropriate treatment are crucial for improving outcomes.