Severe and Prolonged Cholestasis Caused by Trimethoprim-Sulfamethoxazole: A Case Report

Faria, Luciana Costa; Resende, Clarissa C.; Couto, Cláudia Alves; Couto, O. F. M.; Fonseca, L P; Ferrari, Teresa Cristina Abreu

doi:10.1590/s1807-59322009000100014

Cited by 12 publications

(11 citation statements)

References 11 publications

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“…Bile duct injury is not an uncommon complication associated with intra-arterial chemotherapy for treatment of malignancy (60). Chemotherapeutic agents have direct toxic effects on the bile ducts and indirect embolization effects from chemotherapy beads, resulting in diminutive ducts and, ultimately, ductopenia (60,61). More than 30 medications have been implicated in drug-induced ductopenia, most commonly the immunosuppressive cyclosporine, the antibiotic trimethoprim-sulfamethoxazole, and the antipsychotic chlorpromazine (62,63).…”

Section: Cholestatic Injurymentioning

confidence: 99%

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Imaging of Drug-induced Complications in the Gastrointestinal System

McGettigan¹,

Menias²,

Gao³

et al. 2016

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Drug-induced injury commonly affects the gastrointestinal and hepatobiliary systems because of the mechanisms of absorption and metabolism. In pill esophagitis, injury is frequently related to direct contact with the esophageal mucosa, resulting in small superficial ulcers in the mid esophagus. Nonsteroidal anti-inflammatory drugs can lead to gastrointestinal tract ulcers and small bowel mucosal diaphragms (thin weblike strictures). Injury to the pancreatic and hepatobiliary systems can manifest as pancreatitis, acute or chronic hepatitis, cholestasis, or steatosis and steatohepatitis (which may progress to cirrhosis). Various drugs may also insult the hepatic vasculature, resulting in Budd-Chiari and sinusoidal obstructive syndromes. Focal lesions such as hepatic adenomas may develop after use of oral contraceptives or anabolic steroids. Ultrasonography, computed tomography, and magnetic resonance imaging can aid in diagnosis of drug-induced injuries and often are necessary to exclude other causes.

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Section: Cholestatic Injurymentioning

confidence: 99%

“…Differential Diagnosis.-In a patient with cholestatic liver injury, imaging is important to exclude other causes of biliary obstruction such as cholelithiasis (54,56,59,61). Other extrahepatic causes of cholestasis include choledocholithiasis or bile duct tumor and pancreatitis or pancreatic tumor.…”

Section: Cholestatic Injurymentioning

confidence: 99%

Imaging of Drug-induced Complications in the Gastrointestinal System

McGettigan¹,

Menias²,

Gao³

et al. 2016

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“…It may worsen pre-existing renal dysfunction, and hyperkalaemia can occur particularly at high dose or in combination with drugs that affect potassium levels [102], especially in the elderly [121]. Derangement of liver enzymes, and rarely hepatic failure, have also been reported [122,123]. It is not recommended for infants in the first 4 weeks of life or in the last month of pregnancy because of the potential to cause neonatal kernicterus.…”

Section: Adverse Effects Of Trimethoprim/sulfamethoxazolementioning

confidence: 99%

Antibiotic therapy for inducible AmpC β-lactamase-producing Gram-negative bacilli: what are the alternatives to carbapenems, quinolones and aminoglycosides?

Harris

Ferguson

2012

International Journal of Antimicrobial Agents

109

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“…The time interval between the first administration of TMP-SMX and the onset of cholestasis was from 1 day to 3 weeks in adult cases, while it was 5 days in the present case (Table 1) [14]. Symptoms associated with drug-induced VBDS are nonspecific, such as fatigue, poor oral intake, abdominal pain, and weight loss.…”

Section: Discussionmentioning

confidence: 88%

Urosodeoxycholic Acid Therapy in a Child with Trimethoprim-Sulfamethoxazole-induced Vanishing Bile Duct Syndrome

Cho

Jwa

Kim

et al. 2013

Pediatr Gastroenterol Hepatol Nutr

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We present a case of a 7-year-old boy who had cholestasis after trimethoprim-sulfamethoxazole combination therapy. Liver biopsy was performed 36 days after the onset of jaundice because of no evidence of improving cholestasis. Liver histology revealed portal inflammation, bile plug, and biliary stasis around the central vein with the loss of the interlobular bile ducts. Immunohistochemical stains for cytokeratin 7 and 19 were negative. These findings were consistent with those of vanishing bile duct syndrome (VBDS). Chlestasis was progressively improved with dose increment of urosodeoxycholic acid from conventional to high dose. This is the first case report of trimethoprime-sulfamethoxazole associated VBDS in Korean children. The case suggests that differential diagnosis of VBDS should be considered in case of progressive cholestatic hepatitis with elevation of alkaline phosphatase and gamma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.

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Severe and Prolonged Cholestasis Caused by Trimethoprim-Sulfamethoxazole: A Case Report

Cited by 12 publications

References 11 publications

Imaging of Drug-induced Complications in the Gastrointestinal System

Imaging of Drug-induced Complications in the Gastrointestinal System

Antibiotic therapy for inducible AmpC β-lactamase-producing Gram-negative bacilli: what are the alternatives to carbapenems, quinolones and aminoglycosides?

Urosodeoxycholic Acid Therapy in a Child with Trimethoprim-Sulfamethoxazole-induced Vanishing Bile Duct Syndrome

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