Approach to a Patient with Elevated Serum Alkaline Phosphatase

被引：94

作者：

Siddique, Asma ^{[2
]}

Kowdley, Kris V. ^{[1
]}

机构：

[1] Virginia Mason Med Ctr, Benaroya Res Inst, Liver Ctr Excellence, Inst Digest Dis, Seattle, WA 98101 USA

[2] Inst Digest Dis, Ctr Liver Dis, Dept Gastroenterol, Seattle, WA 98111 USA

来源：

CLINICS IN LIVER DISEASE | 2012年 / 16卷 / 02期

关键词：

Cholestasis; Bile; Cirrhosis; Liver; PRIMARY SCLEROSING CHOLANGITIS; PRIMARY BILIARY-CIRRHOSIS; TOTAL PARENTERAL-NUTRITION; MAGNETIC-RESONANCE CHOLANGIOPANCREATOGRAPHY; CHOLESTATIC LIVER-DISEASE; INTRAHEPATIC CHOLESTASIS; URSODEOXYCHOLIC ACID; AUTOIMMUNE PANCREATITIS; CONTROLLED-TRIAL; BILE-ACIDS;

D O I：

10.1016/j.cld.2012.03.012

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

100201 [内科学];

摘要：

Cholestasis develops either from a defect in bile synthesis, impairment in bile secretion, or obstruction to bile flow, and is characterized by an elevated serum alkaline phosphatase and gamma-glutamyltransferase disproportionate to elevation of aminotransferase enzymes. Key elements to the diagnostic workup include visualization of the biliary tree by cholangiography and evaluation of liver histology. The hope is that recent advances in understanding the genetic factors and immune mechanisms involved in the pathogenesis of cholestasis will lead to newer therapeutic interventions in the treatment of these diseases.

引用

页码：199 / +

页数：32

共 207 条

[1]

Sclerosing cholangitis: A focus on secondary causes [J].

Abdalian, Rupert ;

Heathcote, E. Jenny .

HEPATOLOGY, 2006, 44 (05) :1063-1074

[2]

Human bile salt export pump promoter is transactivated by the farnesoid X receptor/bile acid receptor [J].

Ananthanarayanan, M ;

Balasubramanian, N ;

Makishima, M ;

Mangelsdorf, DJ ;

Suchy, FJ .

JOURNAL OF BIOLOGICAL CHEMISTRY, 2001, 276 (31) :28857-28865

[3]

Magnetic resonance cholangiography in patients with biliary disease: its role in primary sclerosing cholangitis [J].

Angulo, P ;

Pearce, DH ;

Johnson, CD ;

Henry, JJ ;

LaRusso, NF ;

Petersen, BT ;

Lindor, KD .

JOURNAL OF HEPATOLOGY, 2000, 33 (04) :520-527

[4]

[Anonymous], 2002, NIH Consensus and State-of-the-Science Statements, V19, P1

[5]

Molecular aspects of bile formation and cholestasis [J].

Arrese, M ;

Trauner, M .

TRENDS IN MOLECULAR MEDICINE, 2003, 9 (12) :558-564

[6]

Diagnosis and treatment of hepatic sarcoidosis [J].

Ayyala U.S. ;

Padilla M.L. .

Current Treatment Options in Gastroenterology, 2006, 9 (6) :475-483

[7]

Clinical trial: modulation of human placental multidrug resistance proteins in cholestasis of pregnancy by ursodeoxycholic acid [J].

Azzaroli, F. ;

Mennone, A. ;

Feletti, V. ;

Simoni, P. ;

Baglivo, E. ;

Montagnani, M. ;

Rizzo, N. ;

Pelusi, G. ;

De Aloysio, D. ;

Lodato, F. ;

Festi, D. ;

Colecchia, A. ;

Roda, E. ;

Boyer, J. L. ;

Mazzella, G. .

ALIMENTARY PHARMACOLOGY & THERAPEUTICS, 2007, 26 (08) :1139-1146

[8]

EFFECT OF URSODEOXYCHOLIC ACID ON SERUM-LIPIDS OF PATIENTS WITH PRIMARY BILIARY-CIRRHOSIS [J].

BALAN, V ;

DICKSON, ER ;

JORGENSEN, RA ;

LINDOR, KD .

MAYO CLINIC PROCEEDINGS, 1994, 69 (10) :923-929

[9]

Imaging of liver disease: Comparison between quadruple-phase multidetector computed tomography and magnetic resonance imaging [J].

Balci, N. Cem ;

Befeler, Alex S. ;

Leiva, Paula ;

Pilgram, Thomas K. ;

Havlioglu, Necat .

JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, 2008, 23 (10) :1520-1527

[10]

Jaundice in the intensive care unit [J].

Bansal, Vishal ;

Schuchert, Vaishali Dixit .

SURGICAL CLINICS OF NORTH AMERICA, 2006, 86 (06) :1495-+

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