Corticosteroid Therapy in a Case of Severe Cholestasic Hepatitis Associated with Amoxicillin-Clavulanate

被引：17

作者：

Herrero-Herrero J.-I. ^{[1
]}

García-Aparicio J. ^{[1
]}

机构：

[1] Service of Internal Medicine-Los Montalvos, Universitary Hospital of Salamanca, Salamanca

来源：

Journal of Medical Toxicology | 2010年 / 6卷 / 4期

关键词：

Amoxicillin-clavulanate; Drug-induced liver injury; Hepatotoxicity;

D O I：

10.1007/s13181-010-0019-4

中图分类号：

学科分类号：

摘要：

Amoxicillin-clavulanate is the most common drug involved in drug-induced liver injury and the single most frequently prescribed product leading to hospitalization for drug-induced liver disease in Spain. The liver damage most frequently associated with amoxicillin-clavulanate is cholestasic type. The latency period between first intake and onset of symptoms is 3-4 weeks on average. A 76-year-old man developed fever, pruritus, and jaundice 3 weeks after having completed treatment with amoxicillin-clavulanate. Liver function tests showed cholestasic hepatitis (up to 50.75 mg/dL of total serum bilirubin level). The ultrasound-guided liver biopsy revealed severe canalicular cholestasis and portal and lobular eosinophilic infiltrates. Prednisone and ursodeoxycholic acid therapy were then prescribed. The patient became symptom-free with normal liver function tests. Amoxicillin-clavulanate can cause hepatocellular, cholestasic, or mixed liver injury. The presence of eosinophilic infiltrates in the liver biopsy and the clinical signs of hypersensitivity in some of the cholestasic cases suggest a pathophysiological immunoallergic mechanism. For this reason, corticosteroid treatment should be considered for patients with severe cholestasic liver injury. © 2010 American College of Medical Toxicology.

引用

页码：420 / 423

页数：3

共 17 条

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