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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
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author Guimarães, Fernando
author2 Regadas, Maria João
Roquete, Pedro
author2_role author
author
author_facet Guimarães, Fernando
Regadas, Maria João
Roquete, Pedro
author_role author
country_str PT
creators_json_txt [{\"Person.name\":\"Guimarães, Fernando\"},{\"Person.name\":\"Regadas, Maria João\"},{\"Person.name\":\"Roquete, Pedro\"}]
datacite.creators.creator.creatorName.fl_str_mv Guimarães, Fernando
Regadas, Maria João
Roquete, Pedro
datacite.rights.fl_str_mv http://purl.org/coar/access_right/c_abf2
datacite.subjects.subject.fl_str_mv Ticlopidina
colestase
hepatite medicamentosa
Ticlopidine
cholestasis
drug - induced hepatitis
datacite.titles.title.fl_str_mv Ticlopidine – induced hepatic toxicity – three clinical case reports
Hepatotoxicidade por ticlopidina - a propósito de três casos clínicos
dc.creator.none.fl_str_mv Guimarães, Fernando
Regadas, Maria João
Roquete, Pedro
dc.description.none.fl_str_mv A ticlopidina é utilizada em larga escala naactualidade. Tem sido ocasionalmente responsabilizada por importante hepatotoxicidade. Publicamosneste artigo três casos de hepatite colestática porticlopidina observados nos últimos anos na nossainstituição. Todos os doentes eram de sexomasculino, com consumo regular significativo deetanol, e tiveram grave icterícia colestáticasintomática. Em todos foi efectuada biopsia hepática,com resultado consistente com colestase tóxica,sendo de salientar em dois a presença de granulomas. Dois dos doentes atingiram valores defosfatase alcalina e gamaglutamiltransferase e decolesterol excepcionalmente elevados. Em doisdoentes, embora clinicamente bem, mais de onzemeses após a suspensão do fármaco persistiaevidência enzimática de colestase. Um doente teveinicialmente anemia acentuada, reversível, cujaetiologia não conseguimos estabelecer. Após brevealusão genérica à problemática da toxicidademedicamentosa aguda sobre o fígado, confrontámosos nossos casos com outros casos de hepatitecolestática induzida pela ticlopidina relatados naliteratura internacional.
dc.format.none.fl_str_mv application/pdf
dc.identifier.none.fl_str_mv https://revista.spmi.pt/index.php/rpmi/article/view/1908
dc.language.none.fl_str_mv por
dc.publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Interna
dc.rights.none.fl_str_mv http://purl.org/coar/access_right/c_abf2
dc.rights.rights.copyright.fl_str_mv https://creativecommons.org/licenses/by-nc/4.0
dc.source.none.fl_str_mv Internal Medicine; Vol. 8 No. 3 (2001): Julho/ Setembro; 132-137
Medicina Interna; Vol. 8 N.º 3 (2001): Julho/ Setembro; 132-137
2183-9980
0872-671X
dc.subject.none.fl_str_mv Ticlopidina
colestase
hepatite medicamentosa
Ticlopidine
cholestasis
drug - induced hepatitis
dc.title.fl_str_mv Ticlopidine – induced hepatic toxicity – three clinical case reports
Hepatotoxicidade por ticlopidina - a propósito de três casos clínicos
dc.type.none.fl_str_mv http://purl.org/coar/resource_type/c_6501
description 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.
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inst_facet_str urn:organizationAcronym:spmi{{{_:::_}}}Sociedade Portuguesa de Medicina Interna
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oai_identifier_str oai:oai.revista.spmi.pt:article/1908
organization_str_mv urn:organizationAcronym:spmi
person_str_mv Guimarães, Fernando
Regadas, Maria João
Roquete, Pedro
publishDate 2001
publisher.none.fl_str_mv Sociedade Portuguesa de Medicina Interna
repo_facet_str urn:repositoryAcronym:spmi{{{_:::_}}}Revista Portuguesa de Medicina Interna
reponame_str Revista Portuguesa de Medicina Interna
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service_str_mv urn:repositoryAcronym:spmi
spelling en-USTiclopidine – induced hepatic toxicity – three clinical case reportspt-PTHepatotoxicidade por ticlopidina - a propósito de três casos clínicosGuimarães, FernandoRegadas, Maria JoãoRoquete, PedroTiclopidinacolestasehepatite medicamentosaTiclopidinecholestasisdrug - induced hepatitishttp://purl.org/coar/access_right/c_abf2https://revista.spmi.pt/index.php/rpmi/article/view/1908URLhttps://revista.spmi.pt/index.php/rpmi/article/view/1908URLHasVersionhttps://revista.spmi.pt/index.php/rpmi/article/view/1908/1338URLHasVersion2001-09-28en-USTiclopidine 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.pt-PTA ticlopidina é utilizada em larga escala naactualidade. Tem sido ocasionalmente responsabilizada por importante hepatotoxicidade. Publicamosneste artigo três casos de hepatite colestática porticlopidina observados nos últimos anos na nossainstituição. Todos os doentes eram de sexomasculino, com consumo regular significativo deetanol, e tiveram grave icterícia colestáticasintomática. Em todos foi efectuada biopsia hepática,com resultado consistente com colestase tóxica,sendo de salientar em dois a presença de granulomas. Dois dos doentes atingiram valores defosfatase alcalina e gamaglutamiltransferase e decolesterol excepcionalmente elevados. Em doisdoentes, embora clinicamente bem, mais de onzemeses após a suspensão do fármaco persistiaevidência enzimática de colestase. Um doente teveinicialmente anemia acentuada, reversível, cujaetiologia não conseguimos estabelecer. Após brevealusão genérica à problemática da toxicidademedicamentosa aguda sobre o fígado, confrontámosos nossos casos com outros casos de hepatitecolestática induzida pela ticlopidina relatados naliteratura internacional.Sociedade Portuguesa de Medicina Internaapplication/pdfen-USInternal Medicine; Vol. 8 No. 3 (2001): Julho/ Setembro; 132-137pt-PTMedicina Interna; Vol. 8 N.º 3 (2001): Julho/ Setembro; 132-1372183-99800872-671Xporjournal articlehttp://purl.org/coar/resource_type/c_6501literatureVoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85https://creativecommons.org/licenses/by-nc/4.0
spellingShingle Ticlopidine – induced hepatic toxicity – three clinical case reports
Guimarães, Fernando
Ticlopidina
colestase
hepatite medicamentosa
Ticlopidine
cholestasis
drug - induced hepatitis
status SINGLETON
status_str VoR
subject.fl_str_mv Ticlopidina
colestase
hepatite medicamentosa
Ticlopidine
cholestasis
drug - induced hepatitis
title Ticlopidine – induced hepatic toxicity – three clinical case reports
title_full Ticlopidine – induced hepatic toxicity – three clinical case reports
title_fullStr Ticlopidine – induced hepatic toxicity – three clinical case reports
title_full_unstemmed Ticlopidine – induced hepatic toxicity – three clinical case reports
title_short Ticlopidine – induced hepatic toxicity – three clinical case reports
title_sort Ticlopidine – induced hepatic toxicity – three clinical case reports
topic Ticlopidina
colestase
hepatite medicamentosa
Ticlopidine
cholestasis
drug - induced hepatitis
topic_facet Ticlopidina
colestase
hepatite medicamentosa
Ticlopidine
cholestasis
drug - induced hepatitis
url https://revista.spmi.pt/index.php/rpmi/article/view/1908
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