DRUG-INDUCED CHOLESTASIS WITH BILE-DUCT INJURY

This article summarizes our present knowledge concerning drug-induced cholestasis by lesions of the bile ducts. Acute or chronic ductular and ductal cholestasis are induced by a few drugs. The acute form may mimick viral hepatitis or biliary tract obstruction. The outcome is generally good. The mechanism may be immunoallergic. The clinical presentation of the chronic form resembles that of primary biliary cirrhosis or sclerosing cholangitis. Its prognosis is generally good and characterized by a complete recovery. However, an evolution to biliary cirrhosis is sometimes possible. The mechanism could also be immunoallergic. Extrahepatic cholestasis is frequently observed after intra-arterial infusion of floxuridine. The prognosis is generally poor. The mechanism of this sclerosing cholangitis may be ischaemic.