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Ductopenia and cirrhosis in a 32-year-old woman with progressive familial intrahepatic cholestasis type 3: A case report and review of the literature.

Abstract
Progressive familial intrahepatic cholestasis type 3 is caused by a mutation in the ATP-binding cassette, subfamily B, member 4 (ABCB4) gene encoding multidrug resistance protein 3. A 32-year-old woman with a history of acute hepatitis at age 9 years was found to have jaundice during pregnancy in 2008, and was diagnosed as having intrahepatic cholestasis of pregnancy. In 2009, she underwent cholecystectomy for gallstones and chronic cholecystitis. However, itching and jaundice did not resolve postoperatively. She was admitted to our hospital with fatigue, jaundice, and a recently elevated γ-glutamyl transpeptidase level. Liver biopsy led to the diagnosis of biliary cirrhosis with ductopenia. Genetic testing revealed a pathogenic heterozygous mutation, ex13 c.1531G > A (p.A511T), in the ABCB4 gene. Her father did not carry the mutation, but her mother's brother carried the heterozygous mutation. We made a definitive diagnosis of familial intrahepatic cholestasis type 3. Her symptoms and liver function improved after 3 mo of treatment with ursodeoxycholic acid.
AuthorsYou-Wen Tan, Hai-Lei Ji, Zhong-Hua Lu, Guo-Hong Ge, Li Sun, Xin-Bei Zhou, Jian-Hui Sheng, Yu-Hua Gong
JournalWorld journal of gastroenterology (World J Gastroenterol) Vol. 24 Issue 41 Pg. 4716-4720 (Nov 07 2018) ISSN: 2219-2840 [Electronic] United States
PMID30416319 (Publication Type: Case Reports, Journal Article, Review)
Chemical References
  • ATP Binding Cassette Transporter, Subfamily B
  • Ursodeoxycholic Acid
  • multidrug resistance protein 3
  • gamma-Glutamyltransferase
Topics
  • ATP Binding Cassette Transporter, Subfamily B (deficiency, genetics)
  • Adult
  • Bile Ducts, Intrahepatic (pathology)
  • Biopsy
  • Cholestasis, Intrahepatic (diagnosis, drug therapy, genetics, pathology)
  • DNA Mutational Analysis
  • Female
  • Genetic Testing
  • Humans
  • Liver (pathology)
  • Liver Cirrhosis (diagnosis, genetics, pathology)
  • Ursodeoxycholic Acid (therapeutic use)
  • gamma-Glutamyltransferase (blood)

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