Cholestatische Hepatitis als seltene Nebenwirkung einer Therapie mit Ticlopidin
| Autor: | P Knoflach, R Berent, W Höbling, A. Haidenthaler, Johann Auer, G Hinterholzer |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
medicine.medical_specialty
Aspirin medicine.diagnostic_test Bilirubin Cerebral infarction business.industry Gastroenterology medicine.disease Surgery Discontinuation chemistry.chemical_compound chemistry Cholestasis Internal medicine Liver biopsy medicine Ticlopidine Complication business medicine.drug |
| Zdroj: | Zeitschrift für Gastroenterologie. 38:587-591 |
| ISSN: | 1439-7803 0044-2771 |
| Popis: | A 71-year-old man with chronic atrial fibrillation was treated with aspirin because of a right cerebral infarction. Oral anticoagulation was not initiated because of a secondary hemorrhagic transformation. Six years later after a left cerebral transient ischemic attack aspirin was replaced by ticlopidine. Two weeks after starting ticlopidine he experienced abdominal cramps and diarrhea. Also dark urine and gray-colored stools were noticed, so that the patient stopped taking ticlopidine. 40 days after starting ticlopidine he was admitted to our hospital because of cholestatic jaundice. Serum alkaline phosphatase (305 U/l) and gamma GT (143 U/l) were elevated, the total bilirubin was 18.6 mg/dl at peak. GOT and GPT were 2.7 fold increased. After exclusion of a viral infection and autoimmune disease liver biopsy was performed, which showed a centroacinar cholestasis compatible with a drug-induced liver damage. 79 days after discontinuation of the drug laboratory signs of cholestasis had disappeared. In patients in whom long-term therapy with ticlopidine is indicated regularly laboratory tests and clinical examinations should be done to recognize infrequent side effects such as the cholestatic hepatitis in time. |
| Databáze: | OpenAIRE |
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