Secondary Sclerosing Cholangitis (SSC) Following Chemotherapy

 

Secondary sclerosing cholangitis has been reported with:

(1) hepatic arterial infusion chemotherapy (HAIC)

(2) bevacizumab and potentially other anti-VEGF agents which can cause an ischemic cholangiopathy

 

The diagnosis of chemotherapy-induced SSC involves:

(1) history of implicated chemotherapy

(2) development afterwards of cholestatic syndrome with abnormal liver function tests

(3) presence of multifocal strictures and dilatations of the intrahepatic bile ducts seen on imaging studies

(4) absence of biliary tract disorder prior to chemotherapy

(5) exclusion of other explanations for secondary sclerosing cholangitis

(6) variable improvement after discontinuing the chemotherapeutic agent