Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives

Vanishing bile duct syndrome (VBDS) is a rare condition, representing approximately 0.5% of small bile duct diseases, characterized by progressive destruction of intrahepatic bile ducts, leading to ductopenia. This condition encompasses various etiologies, with drug-induced VBDS (D-VBDS) accounting...

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Main Authors: Sugunah Sallapan, Kyrillos Faragalla, Hanlin L. Wang, Cherry Pun, Jimin Liu
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2025-04-01
Series:Exploration of Medicine
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Online Access:https://www.explorationpub.com/uploads/Article/A1001302/1001302.pdf
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author Sugunah Sallapan
Kyrillos Faragalla
Hanlin L. Wang
Cherry Pun
Jimin Liu
author_facet Sugunah Sallapan
Kyrillos Faragalla
Hanlin L. Wang
Cherry Pun
Jimin Liu
author_sort Sugunah Sallapan
collection DOAJ
description Vanishing bile duct syndrome (VBDS) is a rare condition, representing approximately 0.5% of small bile duct diseases, characterized by progressive destruction of intrahepatic bile ducts, leading to ductopenia. This condition encompasses various etiologies, with drug-induced VBDS (D-VBDS) accounting for 7% of VBDS cases. D-VBDS arises from liver injury due to chemical drugs, traditional medicines, and dietary supplements, often resulting in inflammatory responses and necrosis of bile duct epithelium. Recent years have seen a rise in reported cases, making drug-related injuries a leading cause of acute liver failure in Western countries. This review provides a comprehensive analysis of VBDS, focusing on the histopathological features of acute and chronic D-VBDS, alongside exploring its clinical presentation, prognostic implications, and future research directions. Understanding the diverse etiologies, clinical manifestations, and biochemical parameters associated with D-VBDS is essential for improving diagnosis, treatment strategies, and patient outcomes.
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spelling doaj-art-cc37bbdd448141348ed07ebf0fbca1e02025-08-20T03:08:43ZengOpen Exploration Publishing Inc.Exploration of Medicine2692-31062025-04-016100130210.37349/emed.2025.1001302Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectivesSugunah Sallapan0https://orcid.org/0000-0002-1465-5812Kyrillos Faragalla1https://orcid.org/0000-0001-7888-676XHanlin L. Wang2Cherry Pun3https://orcid.org/0000-0001-5613-2502Jimin Liu4https://orcid.org/0000-0003-1145-3999Department of Pathology and Laboratory Medicine, Mount Sinai Hospital and Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 1X5, Canada; Histopathology Unit, Department of Pathology, Hospital Kuala Lumpur, Kuala Lumpur 50586, MalaysiaGeneral Internal Medicine, Western University, London, ON N6A 5A5, CanadaDepartment of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA 90095, USADepartment of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, CanadaDepartment of Pathology and Laboratory Medicine, Mount Sinai Hospital, Toronto, ON M5G 1X5, CanadaVanishing bile duct syndrome (VBDS) is a rare condition, representing approximately 0.5% of small bile duct diseases, characterized by progressive destruction of intrahepatic bile ducts, leading to ductopenia. This condition encompasses various etiologies, with drug-induced VBDS (D-VBDS) accounting for 7% of VBDS cases. D-VBDS arises from liver injury due to chemical drugs, traditional medicines, and dietary supplements, often resulting in inflammatory responses and necrosis of bile duct epithelium. Recent years have seen a rise in reported cases, making drug-related injuries a leading cause of acute liver failure in Western countries. This review provides a comprehensive analysis of VBDS, focusing on the histopathological features of acute and chronic D-VBDS, alongside exploring its clinical presentation, prognostic implications, and future research directions. Understanding the diverse etiologies, clinical manifestations, and biochemical parameters associated with D-VBDS is essential for improving diagnosis, treatment strategies, and patient outcomes.https://www.explorationpub.com/uploads/Article/A1001302/1001302.pdfvanishing bile duct syndrome (vbds)drug-induced vbds (d-vbds)drug-induced liver injury (dili)ductopenia
spellingShingle Sugunah Sallapan
Kyrillos Faragalla
Hanlin L. Wang
Cherry Pun
Jimin Liu
Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives
Exploration of Medicine
vanishing bile duct syndrome (vbds)
drug-induced vbds (d-vbds)
drug-induced liver injury (dili)
ductopenia
title Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives
title_full Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives
title_fullStr Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives
title_full_unstemmed Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives
title_short Vanishing bile duct syndrome in drug-induced liver injury: clinical and pathologic perspectives
title_sort vanishing bile duct syndrome in drug induced liver injury clinical and pathologic perspectives
topic vanishing bile duct syndrome (vbds)
drug-induced vbds (d-vbds)
drug-induced liver injury (dili)
ductopenia
url https://www.explorationpub.com/uploads/Article/A1001302/1001302.pdf
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AT hanlinlwang vanishingbileductsyndromeindruginducedliverinjuryclinicalandpathologicperspectives
AT cherrypun vanishingbileductsyndromeindruginducedliverinjuryclinicalandpathologicperspectives
AT jiminliu vanishingbileductsyndromeindruginducedliverinjuryclinicalandpathologicperspectives