Cholestasis causes

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

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Causes

There are many causes of cholestasis.

• Extrahepatic cholestasis occurs outside the liver. It can be caused by:

• Bile duct tumors
• Cysts
• Narrowing of the bile duct (strictures)
• Stones in the common bile duct
• Pancreatitis
• Pancreatic tumor or pseudocyst
• Pressure on an organ due to a nearby mass or tumor
• Primary sclerosing cholangitis

• Intrahepatic cholestasis occurs inside the liver. It can be caused by:

• Alcoholic liver disease
• Amyloidosis
• Bacterial abscess in the liver
• Being fed through a vein (IV)
• Lymphoma
• Intrahepatic cholestasis of pregnancy
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Sarcoidosis
• Serious infections that have spread through the bloodstream (sepsis)
• Tuberculosis
• Viral hepatitis
• Sjogren syndrome

• Certain medications can also cause cholestasis.

Causes by Organ System

Cardiovascular	No underlying causes
Chemical / poisoning	Gold salts
Dermatologic	Obesity due to pro-opiomelanocortin Deficiency
Drug Side Effect	Amoxicillin, Ampicillin, Anabolic steroids, Benoxaprofen, Cefadroxil, Cefotaxime sodium, Ceftazidime, Chlorpromazine, Cimetidine, Clomipramine, Clonazepam, Combined oral contraceptive pill, Diazepam, Diflunisal, Ethynodiol diacetate and ethinyl estradiol, Erythromycin estolate, Esterified estrogens, Flucloxacillin, Glibenclamide, Glimepiride, Imipramine, Indomethacin, Levomepromazine, Lorazepam, Medroxyprogesterone, Mercaptopurine, Meropenem, Methyltestosterone, Minocycline hydrochloride, Nalidixic acid, Nandrolone, Nitrofurantoin, Oxazepam, Para-amino salicylic acid, Penicillamine, Penicillin, Perazine, Phenylbutazone, Pipothiazine, Prochlorperazine, Proguanil, Pyritinol, Rifampicin, Sulfasalazine, Sulindac, Temazepam, Terbinafine, Tolbutamide, Zonisamide
Ear Nose Throat	No underlying causes
Endocrine	Neonatal diabetes-congenital hypothyroidism-congenital glaucoma-hepatic fibrosis-polycystic kidneys, Obesity due to pro-opiomelanocortin Deficiency
Environmental	No underlying causes
Gastroenterologic	Neonatal diabetes-congenital hypothyroidism-congenital glaucoma-hepatic fibrosis-polycystic kidneys, Bile duct paucity, non syndromic form, Bile duct stricture, Biliary atresia, Biliary sludge, Carcinoma of ampulla of Vater, Caroli disease, Cholangiocarcinoma, Choledochal cyst, Choledocholithiasis, Cholelithiasis, Cholestasis-pigmentary retinopathy-cleft palate, Gallbladder cancer, Hepatic adenoma, Hepatic ductular hypoplasia, Hepatocellular carcinoma, Intrahepatic cholestasis of pregnancy, Klatskin tumor (bile duct bifurcation), Mirizzi syndrome, Pancreatic cancer, Obesity due to pro-opiomelanocortin Deficiency, Aagenaes syndrome, Alagille syndrome, Benign intrahepatic cholestasis, Dubin-Johnson syndrome, GRACILE syndrome, North American Indian childhood cirrhosis, Progressive familial intrahepatic cholestasis , Rotor syndrome, Cholangitis, Liver metastases, Lutz-Richner and Landolt syndrome, Primary biliary cirrhosis, Primary sclerosing cholangitis, , Lathosterolosis, Cystic fibrosis, COACH syndrome, Pancreatitis, Liver abscess, Alcoholic liver disease, Viral hepatitis, Alpha 1-antitrypsin deficiency, Bile acid synthesis defects
Genetic	Aagenaes syndrome, Alagille syndrome, Benign intrahepatic cholestasis, Citrullinemia type 2, Cystic fibrosis, Dubin-Johnson syndrome, GRACILE syndrome, Lathosterolosis, Mitochondrial DNA depletion syndrome, hepatocerebral form, North American Indian childhood cirrhosis, Obesity due to pro-opiomelanocortin Deficiency, Progressive familial intrahepatic cholestasis , Rotor syndrome, Zellweger spectrum, COACH syndrome, Alpha 1-antitrypsin deficiency, Erythropoietic protoporphyria
Hematologic	Aagenaes syndrome, Lymphoma
Iatrogenic	Bile duct paucity in Graft-Versus-Host Disease, Long term intravenous nutrition
Infectious Disease	Alveolar hydatid disease, Ascariasis, Cholangitis, Clonorchiasis, Liver abscess, Tuberculosis, Viral hepatitis, Sepsis
Musculoskeletal / Ortho	GRACILE syndrome, Lathosterolosis, Cholestasis-pigmentary retinopathy-cleft palate
Neurologic	COACH syndrome, Zellweger spectrum
Nutritional / Metabolic	GRACILE syndrome, Citrullinemia type 2, Lathosterolosis, Mitochondrial DNA depletion syndrome, hepatocerebral form, Amyloidosis, Erythropoietic protoporphyria
Obstetric/Gynecologic	Intrahepatic cholestasis of pregnancy, Pregnancy
Oncologic	Liver metastases, Carcinoma of ampulla of Vater, Cholangiocarcinoma, Gallbladder cancer, Hepatic adenoma, Hepatocellular carcinoma, Klatskin tumor (bile duct bifurcation), Pancreatic cancer, Lymphoma
Opthalmologic	Neonatal diabetes-congenital hypothyroidism-congenital glaucoma-hepatic fibrosis-polycystic kidneys, Cholestasis-pigmentary retinopathy-cleft palate, COACH syndrome
Overdose / Toxicity	Benoxaprofen, Chlorpromazine, Clomipramine, Clonazepam, Combined oral contraceptive pill, Diazepam, Erythromycin estolate, Flucloxacillin, Glibenclamide, Glimepiride, Imipramine, Indomethacin, Levomepromazine, Lorazepam, Nalidixic acid, Nitrofurantoin, Oxazepam, Para-amino salicylic acid, Penicillamine, Perazine, Phenylbutazone, Pipothiazine, Proguanil, Pyritinol, Rifampicin, Temazepam, Anabolic steroids, Cimetidine, Prochlorperazine, Terbinafine, Tolbutamide, Ampicillin, Penicillin
Psychiatric	No underlying causes
Pulmonary	Cystic fibrosis, Sarcoidosis, Tuberculosis, Alpha 1-antitrypsin deficiency
Renal / Electrolyte	Lutz-Richner and Landolt syndrome, Neonatal diabetes-congenital hypothyroidism-congenital glaucoma-hepatic fibrosis-polycystic kidneys, Zellweger spectrum
Rheum / Immune / Allergy	Primary biliary cirrhosis, Primary sclerosing cholangitis, Sarcoidosis, COACH syndrome, Amyloidosis
Sexual	Cystic fibrosis
Trauma	No underlying causes
Urologic	No underlying causes
Dental	No underlying causes
Miscellaneous	Amyloidosis

Causes in Alphabetical Order

Aagenaes syndrome Alpha 1-antitrypsin deficiency Amoxicillin Ampicillin Amyloidosis Anabolic steroids Alagille syndrome Alcoholic liver disease Alveolar hydatid disease Ascariasis Benign intrahepatic cholestasis Benoxaprofen Bile acid synthesis defects Bile duct paucity in Graft-Versus-Host Disease Bile duct paucity, non syndromic form Bile duct stricture Biliary atresia Biliary sludge Carcinoma of ampulla of Vater Caroli disease Cefadroxil Ceftazidime Chlorpromazine Cholangiocarcinoma Cholangitis Choledochal cyst Choledocholithiasis Cholelithiasis Cholestasis-pigmentary retinopathy-cleft palate Cimetidine Citrullinemia type 2 Clomipramine Clonazepam Clonorchiasis COACH syndrome Combined oral contraceptive pill Cystic fibrosis Diazepam Dubin-Johnson syndrome Erythromycin estolate Erythropoietic protoporphyria Flucloxacillin Gallbladder cancer Glibenclamide Glimepiride Gold salts GRACILE syndrome Hepatic adenoma

Hepatic ductular hypoplasia Hepatocellular carcinoma Imipramine Indomethacin Infliximab Intrahepatic cholestasis of pregnancy Klatskin tumor (bile duct bifurcation) Lathosterolosis Levomepromazine Liver abscess Liver metastases Long term intravenous nutrition Lorazepam Lutz-Richner and Landolt syndrome Lymphoma Medroxyprogesterone Mirizzi syndrome Mitochondrial DNA depletion syndrome, hepatocerebral form Nalidixic acid Neonatal diabetes-congenital hypothyroidism-congenital glaucoma-hepatic fibrosis-polycystic kidneys Nitrofurantoin North American Indian childhood cirrhosis Obesity due to pro-opiomelanocortin Deficiency Oxazepam Pancreatic cancer Pancreatitis Para-amino salicylic acid Penicillin Penicillamine Perazine Phenylbutazone Pipothiazine Pregnancy Primary biliary cirrhosis Primary sclerosing cholangitis Prochlorperazine Progressive familial intrahepatic cholestasis Proguanil Pyritinol Rifampicin Rotor syndrome Sarcoidosis Sepsis Temazepam Terbinafine Tolbutamide Tuberculosis Viral hepatitis Zellweger spectrum