A middle-aged man with progressive jaundice

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Worapoth Yingyongthawat, M.D.


vanishing bile duct syndrome, cholestasis jaundice, drug induced liver injury, ductopenia


Vanishing bile duct syndrome is the group of acquired cholestatic liver disease associated with progressive destruction and disappearance of the intrahepatic bile ducts. We report a case of
a 55-years old man with end-stage renal disease and diabetic mellitus who presented with progressive cholestatic jaundice. He had no risk factors for chronic liver disease and hepatotoxic medications.
The liver function tests were cholestasis pattern. The liver biopsy showed severe ductopenia compatible with vanishing bile duct syndrome.

Figure 3 (H&E, 400x) The liver histology shows biliary cirrhosis with “jigsaw-pattern” regenerative nodules (*), lobular, and cholangiolar cholestasis (arrow) (PT = portal tract)


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