I experienced several cases in which data shows liver dysfunction or cholestasis in patients with urinary traction infection without cholangitis. My impression about this phenomenon is that blood culture and/or urine culture reveal positive results. I suppose that cytokines in bloodstream produced by microbes may affect liver as well as renal function. Does anybody know this mechanism or articles discussing this point?
If these patients have been treated with antibiotics then it could be a drug-related phenomenon as antibiotic associated cholestasis is quite common. Otherwise difficult to see how UTI would affect liver function unless as you suggest through cytokines.
There is not a clear understanding of this phenomenon but the following two articles might have some clues:
1.Ohno N, Ota Y, Hatakeyama S, Yanagimoto S, Morisawa Y, Tsukada K, Koike K, Kimura S. A patient with E. coli-induced pyelonephritis and sepsis who transiently exhibited symptoms associated with primary biliary cirrhosis. Intern Med. 2003 Nov;42(11):1144-8.
Smyk DS, Bogdanos DP, Kriese S, Billinis C, Burroughs AK, Rigopoulou EI.Urinary tract infection as a risk factor for autoimmune liver disease: from bench to bedside.
Clin Res Hepatol Gastroenterol. 2012 Apr;36(2):110-21.
Front Biosci (Elite Ed). 2013 Jan 1;5:87-96.
The molecular pathogenesis of cholestasis in sepsis.
Bhogal HK1, Sanyal AJ.
Thanks for helping me with this problem.
Some patients were not given antibiotics when they visited us. I am interested in the idea that cholestasis occurs during the course of sepsis in urinary tract infection.
Nobuhiro
Hello!
I agree with Dr. Ayşe. I think that some patients have a genotype predisposing to autoimmune processes. Through the mechanism of molecular mimicry. In the attached link to the article http://www.biomedcentral.com/1471-230X/11/95
Second. Most patients with urinary infection use herbal medicine alone. It's well known that this may be the cause of liver injury with cholestasis.
Sincerely, Zmicer
One possible explanation could be that a decreased renal clearance, caused by urinary tract infection, is compensated to a certain degree by an increased hepatic clearance, which favors development of cholestasis.
Dr Haurylenka, thanks for giving me the interesting article. The association between PBC and UTI is intriguing.
Dr Warda, your idea could be convincing for the explanation. I appreciate your help!
Nobuhiro
salam Dears ....
Cholestasis can be symptoms for any infection at any site in the body because it is generalized issue and alter the permiability of hepatocyte , this is individual susptability .....My MD thesis in that topic ..Cholestasis
One of the causes of cholestasis is (sepsis induced cholestasis) .
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