Pathophysiology of sepsis‐induced cholestasis: A review
Maria Iuliana Ghenu,
Dorin Dragoş,
Maria Mirabela Manea,
Dorin Ionescu,
Lucian Negreanu
Affiliations
Maria Iuliana Ghenu
1st Department Medical Semiology (MIG, DD, DI), 6th Department Clinical Neurosciences (MMM), 5th Department Internal Medicine (LN) “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
Dorin Dragoş
1st Department Medical Semiology (MIG, DD, DI), 6th Department Clinical Neurosciences (MMM), 5th Department Internal Medicine (LN) “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
Maria Mirabela Manea
1st Department Medical Semiology (MIG, DD, DI), 6th Department Clinical Neurosciences (MMM), 5th Department Internal Medicine (LN) “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
Dorin Ionescu
1st Department Medical Semiology (MIG, DD, DI), 6th Department Clinical Neurosciences (MMM), 5th Department Internal Medicine (LN) “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
Lucian Negreanu
1st Department Medical Semiology (MIG, DD, DI), 6th Department Clinical Neurosciences (MMM), 5th Department Internal Medicine (LN) “Carol Davila” University of Medicine and Pharmacy Bucharest Romania
Abstract Sepsis is a critical condition resulting from the excessive activation of the inflammatory/immune system in response to an infection, with high mortality if treatment is not administered promptly. One of the many possible complications of sepsis is liver dysfunction with consequent cholestasis. The aim of this paper is to review the main mechanisms involved in the development of cholestasis in sepsis. Cholestasis in a septic patient must raise the suspicion that it is the consequence of the septic condition and limit the laborious attempts of finding a hepatic or biliary disease. Prompt antibiotic administration when sepsis is suspected is essential and may improve liver enzymes. Cholestasis is a syndrome with a variety of etiologies, among which sepsis is frequently overlooked, despite a number of studies and case reports in the literature demonstrating not only the association between sepsis and cholestasis but also the role of cholestasis as a prognostic factor for sepsis‐induced death.
