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Ticlopidine – induced hepatic toxicity – three clinical case reports

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Resumo:Ticlopidine is widely used nowadays. It hasoccasionally been responsible for importanthepatotoxicity. We present three case reports of Ticlopidine-induced cholestatic hepatitis, recognised over the last years, at our institution. All three patients were male, with regular significant ethanolintake. They all presented with serious symptomaticcholestatic jaundice. Liver biopsy was performed inall 3 patients and was consistent with toxiccholestasis, and we emphasize the presence ofgranulomas in two of them. In two patients alkalinephosphatase, gamma-glutamyl transpeptidase andcholesterol reached exceptionally high levels.Although clinically well more than eleven monthsafter drug suspension, two patients still presentedlaboratory evidence of cholestasis. One patient hadinitially important but reversible anaemia ofunestablished aetiology. After a short generalintroduction on the subject of acute hepatic drugtoxicity we compare our cases with other ticlopidine-induced cholestatic hepatitis case reports publishedin the international literature.
Autores principais:Guimarães, Fernando
Outros Autores:Regadas, Maria João; Roquete, Pedro
Assunto:Ticlopidina colestase hepatite medicamentosa Ticlopidine cholestasis drug - induced hepatitis
Ano:2001
País:Portugal
Tipo de documento:artigo
Instituição associada:Sociedade Portuguesa de Medicina Interna
Idioma:português
Origem:Revista Portuguesa de Medicina Interna
Descrição
Resumo:Ticlopidine is widely used nowadays. It hasoccasionally been responsible for importanthepatotoxicity. We present three case reports of Ticlopidine-induced cholestatic hepatitis, recognised over the last years, at our institution. All three patients were male, with regular significant ethanolintake. They all presented with serious symptomaticcholestatic jaundice. Liver biopsy was performed inall 3 patients and was consistent with toxiccholestasis, and we emphasize the presence ofgranulomas in two of them. In two patients alkalinephosphatase, gamma-glutamyl transpeptidase andcholesterol reached exceptionally high levels.Although clinically well more than eleven monthsafter drug suspension, two patients still presentedlaboratory evidence of cholestasis. One patient hadinitially important but reversible anaemia ofunestablished aetiology. After a short generalintroduction on the subject of acute hepatic drugtoxicity we compare our cases with other ticlopidine-induced cholestatic hepatitis case reports publishedin the international literature.