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Review
. 2022 Jul 16;20(3):77-80.
doi: 10.1002/cld.1230. eCollection 2022 Sep.

Itching to find a diagnosis

Akash D Patel  1 , Bret L Pinsker  1 , April Wall  2 , Mitchell Arbogast  3 , Lindsay Y King  2 , Sheila Sherzoy  1   4
Affiliations
Review

Itching to find a diagnosis

Akash D Patel et al. Clin Liver Dis (Hoboken). .

Abstract

Content available: Audio Recording.

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Conflict of interest statement

Nothing to report.

Figures

FIGURE 1
FIGURE 1
Hepatic function tests before and after hospital admission. Between weeks −2 and −3 indicates when the patient discontinued ashwagandha supplementation. Until about 4 weeks (week +2) after discontinuation, TBIL and ALP levels continued to increase. Ursodiol was given at week +1. These laboratory values began to decrease shortly after this time.
FIGURE 2
FIGURE 2
Abdominal MRI and MRCP. The liver and pancreas are enhanced homogenously and demonstrate no focal masses. The gallbladder appears normal and is without cholelithiasis. The bile ducts are normal in caliber.
FIGURE 3
FIGURE 3
Representative photomicrographs of cholestatic injury in the liver. (A) Liver parenchyma demonstrating centrilobular severe canalicular cholestasis (original magnification ×20). (B) A portal area demonstrating a bile ductular reaction with associated neutrophils and focal cholate stasis (“feathery degeneration”) in periportal hepatocytes. The interlobular bile ducts demonstrate features of bile duct injury with nuclear hyperchromasia and angulation, nuclear dropout, and rare sloughed ductular epithelial cells.
See this image and copyright information in PMC

References

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