Chemical composition of gallbladder sludge in patients after marrow transplantation

Cynthia W. Ko, Carol Murakami, John H. Sekijima, Myng Hwan Kim, George B. McDonald, Sum P. Lee

Research output: Contribution to journalArticle

29 Citations (Scopus)

Abstract

Objectives: Gallbladder sludge develops in approximately 70% of patients after bone marrow transplantation (BMT). Sludge often develops in these patients without known predisposing factors, such as fasting or narcotic use. In this study, we examined the chemical composition of sludge in BMT patients. Methods: Gallbladder content samples from 15 patients were obtained at autopsy. Presence or absence of sludge was determined by examination of gallbladder contents. Sludge samples were examined with direct and polarizing microscopy and assayed for cholesterol, bilirubin, and calcium content and for the presence of a calcium-binding protein. Results: On microscopic examination, cholesterol monohydrate crystals were almost completely absent. Calcium bilirubinate crystals were present in large amounts in all samples. Calcium-ceftriaxone crystals were found in two patients who had received ceftriaxone. A large proportion of the sludge (84.6%) was found to be 'unmeasurable residue.' Of this part, 5-30% was accounted for by a calcium- binding protein. Conclusions: We conclude that gallbladder sludge in patients after marrow transplantation consists primarily of 'unmeasurable residue,' calcium bilirubinate, and a calcium-binding protein. Cholesterol crystals are almost absent. We conclude that formation of gallbladder sludge in these patients could serve as a model for studying the pathogenesis of pigment gallstones.

Original languageEnglish (US)
Pages (from-to)1207-1210
Number of pages4
JournalAmerican Journal of Gastroenterology
Volume91
Issue number6
StatePublished - Jun 1 1996

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Sewage
Gallbladder
Transplantation
Bone Marrow
Calcium-Binding Proteins
Bilirubin
Ceftriaxone
Cholesterol
Bone Marrow Transplantation
Calcium
Narcotics
Gallstones
Causality
Microscopy
Autopsy
Fasting

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Ko, C. W., Murakami, C., Sekijima, J. H., Kim, M. H., McDonald, G. B., & Lee, S. P. (1996). Chemical composition of gallbladder sludge in patients after marrow transplantation. American Journal of Gastroenterology, 91(6), 1207-1210.

Chemical composition of gallbladder sludge in patients after marrow transplantation. / Ko, Cynthia W.; Murakami, Carol; Sekijima, John H.; Kim, Myng Hwan; McDonald, George B.; Lee, Sum P.

In: American Journal of Gastroenterology, Vol. 91, No. 6, 01.06.1996, p. 1207-1210.

Research output: Contribution to journalArticle

Ko, CW, Murakami, C, Sekijima, JH, Kim, MH, McDonald, GB & Lee, SP 1996, 'Chemical composition of gallbladder sludge in patients after marrow transplantation', American Journal of Gastroenterology, vol. 91, no. 6, pp. 1207-1210.
Ko CW, Murakami C, Sekijima JH, Kim MH, McDonald GB, Lee SP. Chemical composition of gallbladder sludge in patients after marrow transplantation. American Journal of Gastroenterology. 1996 Jun 1;91(6):1207-1210.
Ko, Cynthia W. ; Murakami, Carol ; Sekijima, John H. ; Kim, Myng Hwan ; McDonald, George B. ; Lee, Sum P. / Chemical composition of gallbladder sludge in patients after marrow transplantation. In: American Journal of Gastroenterology. 1996 ; Vol. 91, No. 6. pp. 1207-1210.
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