Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Japan.
Department of Nephrology, Nagoya University Graduate School of Medicine, Japan.
Intern Med. 2024 Jan 1;63(1):57-61. doi: 10.2169/internalmedicine.1826-23. Epub 2023 May 10.
Vanishing bile duct syndrome (VBDS) is a rare but potentially serious cholestatic liver disease caused by various etiologies, including drugs. We herein report a complicated case of VBDS with acute tubular necrosis (ATN) that improved significantly with steroid treatment. An Asian man in his 30s was admitted with the acute onset of severe jaundice and a decline in the renal function. Although initial treatment with ursodeoxycholic acid did not reduce jaundice or renal dysfunction, steroid treatment remarkably improved the VBDS and ATN to within the respective normal ranges. Steroid treatment can be considered in cases of VBDS that appear to have an immune-mediated cause.
胆流消失综合征（VBDS）是一种罕见但潜在严重的胆汁淤积性肝病，由多种病因引起，包括药物。我们在此报告一例伴有急性肾小管坏死（ATN）的复杂 VBDS 病例，该病例经类固醇治疗后显著改善。一名 30 多岁的亚洲男性因急性发作严重黄疸和肾功能下降而入院。虽然初始使用熊去氧胆酸治疗并未减轻黄疸或肾功能障碍，但类固醇治疗显著改善了 VBDS 和 ATN，使其恢复到各自的正常范围。对于疑似免疫介导原因引起的 VBDS 病例，可以考虑使用类固醇治疗。
