Thursday, February 21, 2019

Secondary sclerosing cholangitis in critically ill patients (SSC-CIP)

From a review of this increasingly recognized entity:


SSC-CIP is a rather newly recognized condition that has been gaining more attention in recent years due to rise in ICU treatment-related diseases with improved ICU treatment. SSC-CIP is usually a progressive disease with an aggressive nature leading to liver cirrhosis and hepatic failure without LT.42 During the initial stages of the disease, the clinical symptoms and biochemical profile are not specific and do not differentiate much from endotoxin-associated jaundice, which is a common condition in critically ill patients. Thus, increased awareness and early detection of SSC-CIP and its complications are believed to be crucial to improve the poor prognosis. Biliary casts formation may be considered pathognomonic for SSC-CIP since most patients have them in early stages of the disease and these casts have not been described in the literature in either PSC or IgG4 cholangiopathy.18

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