Cholestasis in Benign Recurrent Intrahepatic Cholestasis 2

Eric Lorio

David Valadez

Naim Alkhouri

Nicole Loo

^{Department of Medicine, University of Texas Health, San Antonio, TX}

^{Division of Gastroenterology, Texas Liver Institute, University of Texas Health, San Antonio, TX}

^{Corresponding author.}

Correspondence: Eric Lorio, MD (ude.ascshtu@oirol).

Received 2019 Oct 17; Accepted 2020 May 8.

This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

ABSTRACT

Benign recurrent intrahepatic cholestasis represents a rare class of autosomal recessive chronic cholestasis disorders, usually presenting with recurrent episodes of intense pruritus and jaundice. We report a 27-year-old woman presenting with benign recurrent intrahepatic cholestasis type 2 due to heterozygosity in ABCB11. Interestingly, she was also found to be heterozygous in cystic fibrosis transmembrane conductance regulator, NPHP4, and A1ATD (SERPINA1), which may explain the severe nature of her disease expression because heterozygosity in each of these genes has been associated with cholestasis. Finally, she exhibited a response to steroids that may have implications for future treatment of bile salt export pump-related diseases.

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