Sepsis-Associated Cholestasis: The Impact of Mitochondrial Dysfunction (A Case Report) Sepsis-Associated Cholestasis: The Impact of Mitochondrial Dysfunction (A Case Report)

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Behzad Noroozi
Ali Mohammad Had
Bita Shahrami
Ayda Vakili Ardabili
Fatemeh Yoonesi
Kaveh Hedayati Emami
Hamid Reza Sharifnia
Mojtaba Mojtahedzadeh


Cholestasis, Critical illness, Hyperbilirubinemia, Liver failure, Sepsis


Introduction: Hyperbilirubinemia – a condition of elevated serum bilirubin above the reference range, is common in hospitalized patients. The reasons for the increase in the bilirubin level can be pre-hepatic, hepatic, and post-hepatic. Sepsis is one of the most important causes of hyperbilirubinemia in critically ill patients.

Case report: We present a 30-year-old woman with no past medical and drug history who was admitted to the intensive care unit (ICU) due to multiple trauma and fractures due to a fall from height. During the ICU stay, the patient developed jaundice with a high increase in the bilirubin level. A diagnosis of sepsis-associated cholestasis was considered after ruling out other possible pathologies. The hyperbilirubinemia improved with the early management of sepsis concomitant supportive medical therapy.

Conclusion: Early recognition and treatment of sepsis as a cause of cholestasis should be considered in ICU patients. Drugs targeting mitochondrial function would provide rapid hepatic recovery reducing complications and mortality.

Keywords: Cholestasis, Critical illness, Hyperbilirubinemia, Liver failure, Sepsis

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