Drug-associated cholelithiasis: a case of sulindac stone formation and the incorporation of sulindac metabolites into the gallstones
| Autor: | Tsuguo Nakamoto, Toru Sunagawa, Fumio Tokumine, Fujihiko Miyazato, Yoshiki Shiohira, Yoshihiro Muto |
|---|---|
| Rok vydání: | 1999 |
| Předmět: |
medicine.medical_specialty
Spectrophotometry Infrared medicine.medical_treatment Intrahepatic bile ducts Gastroenterology Arthritis Rheumatoid Sulindac Cholelithiasis Internal medicine medicine Humans Hepatology business.industry Bile duct Gallbladder Anti-Inflammatory Agents Non-Steroidal Gallstones Middle Aged medicine.disease digestive system diseases medicine.anatomical_structure Biliary tract Rheumatoid arthritis Cholecystectomy Female business medicine.drug |
| Zdroj: | The American journal of gastroenterology. 94(8) |
| ISSN: | 0002-9270 |
| Popis: | A case of drug-associated cholelithiasis (sulindac chlecystohepatolithiasis) in a 63-yr-old woman is reported. The patient was admitted to our hospital to undergo treatment for rheumatoid arthritis of 20 yr duration. She was treated with nonsteroidal anti-inflammatory drugs (NSAID: sulindac). Two months later, she presented with right upper quadrant pain. Diagnostic studies including ultrasonography (US), computed tomography (CT) and endoscopic retrograde cholangiography (ERC), led to the diagnosis of cholecystohepatolithiasis. She underwent cholecystectomy and choledochotomy with an extraction of intrahepatic stones. The intrahepatic stones were light yellow in color with a claylike appearance. Unexpectedly, an infrared spectroscopic analysis of the stone showed it to consist of sulindac metabolites. In addition, the dilated segment of the intrahepatic bile duct naturally returned to its normal size after the discontinuation of the drug administration. This is the first reported case of sulindac stone formation in the bile duct. No similar problems with other NSAIDs have been reported previously. |
| Databáze: | OpenAIRE |
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