vanishing bile duct syndrome (VBDS) (ductopenia)
Last edited 07/2022 and last reviewed 07/2022
Vanishing bile duct syndrome (VBDS) ("ductopenia")
- refers to a group of disorders characterized by prolonged cholestasis as a result of destruction and disappearance of intrahepatic bile ducts
- consists of a series of diseases characterized by the loss of >50% bile duct in portal areas (1)
- multiple etiologies have been indentified including infections, neoplastic disorders, autoimmune conditions and drugs
- exact mechanism underlying this syndrome is unknown; however, common causes include autoimmune disorders such as:
- primary biliary cirrhosis (PBC),
- neoplasms,
- infections
- drug toxicities (2)
- for example cloxacillin, an antistaphylococcal penicillin (3)
- exact mechanism underlying this syndrome is unknown; however, common causes include autoimmune disorders such as:
- natural history of this condition is variable and may involve resolution of cholestasis or progression with irreversible damage
Reference:
- Zhao Z, Bao L, Yu X, Zhu C, Xu J, Wang Y, Yin M, Li Y, Li W. Acute vanishing bile duct syndrome after therapy with cephalosporin, metronidazole, and clotrimazole: A case report. Medicine (Baltimore). 2017 Sep;96(36):e8009.
- Reau NS, Jensen DM. Vanishing bile duct syndrome. Clin Liver Dis. 2008;12:203-217, x.
- Faragalla, K, Lau, H, Wang, HL, Liu, J. Cloxacillin-induced acute vanishing bile duct syndrome: A case study and literature review. Br J Clin Pharmacol. 2022; 1- 6. doi:10.1111/bcp.15445