vanishing bile duct syndrome (idiopathic ductopenia)

Disorder resembling graft versus host disease (GVHD) & liver transplant rejection. Etiology: 1) autoimmune is suggested 2) occurs in patients with Hodgkin's disease 3) occurs as hepatotoxic effect of: a) chlorpromazine b) other phenothiazines c) other medications Pathology: -> paucity of bile ducts in the portal areas Laboratory: 1) mildly elevated transaminases 2) increased alkaline phosphatase 3) increased gamma-glutamultransferase (GGT) 4) elevated bilirubin 5) liver biopsy Radiology: -> cholangiography is normal

References

Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998