An Uncommon Complication of Commonly Used Medication

Bawany, Muhammad; Sofi, Aijaz; Nawras, Ali; Sodeman, Thomas

doi:10.14309/00000434-201110002-00762

Cited by 4 publications

(4 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Liver diseases are dangerous and spread widely, leading to acute liver failures and thus impairing the quality of human life. 28 , 29 , 30 Drug hepatotoxicity can also be a reason for acute liver failure. The symptoms can manifest immediately or several months into therapy.…”

Section: Discussionmentioning

confidence: 99%

Blood coagulation factors and platelet response to drug‐induced hepatitis and hepatosis in rats

Korolova

Gryshchenko

Chernyshenko

et al. 2022

Anim Models and Exp Med

View full text Add to dashboard Cite

The liver plays an important role in maintaining blood hemostasis. It participates in carbohydrate, protein, and lipid metabolism, and eliminates various endogenous and exogenous molecules. A multitude of substances, including vitamins (A, D, B12, K, E, and B1), are stored in its cells. The liver is also the site of synthesis of plasma proteins, most coagulation factors, anticoagulant proteins, compounds of fibrinolysis, and stimulators of erythropoesis. 1 Liver pathologies lead to complex disorders in the blood hemostasis system in which the procoagulant and anticoagulant potentials are imbalanced, causing thrombotic events or hemorrhages. 2,3

show abstract

Section: Discussionmentioning

confidence: 99%

Blood coagulation factors and platelet response to drug‐induced hepatitis and hepatosis in rats

Korolova

Gryshchenko

Chernyshenko

et al. 2022

Anim Models and Exp Med

View full text Add to dashboard Cite

show abstract

“…Їх вираженість залежить від дози ліків, але це буває далеко не завжди. Частіше ураження печінки виникає на тлі лікування декількома гепатотоксичними препаратами або при повторних курсах терапії та залежить від тривалості їх прийому (Chalasani, 2005;Calderon et al, 2010;Bawany et al, 2013;Moole et al, 2015;Okudo and Anusim, 2016).…”

Section: національний університет біоресурсів і природокористування уunclassified

Biochemical properties of the plasma of rats with the experimentally induced hepatitis after oral administration of sodium diclofenac

Gryshchenko¹

2017

Regul. Mech. Biosyst.

View full text Add to dashboard Cite

We conducted an analysis of the metabolic activity of the liver and defined the peculiarities of biochemical parameters and macroelement composition of blood plasma of rats with experimentally induced toxic hepatitis. Hepatopathology was modeled by oral administration of sodium diclofenac at a dose of 12.5 mg/kg of body mass to rats during 14 days. For the preparation of plasma, rat blood was collected from the abdominal aorta into test-tubes with heparin, and then it was centrifuged at 1500 rev./min for 15–20 min. Then we studied biochemical parameters of blood indicators (level of total protein, albumin, total and conjugated bilirubin, glucose, creatinine, urea, triacylglycerols, cholesterol, thymol test value, activities of ALT, AST, LP and GGT, amylase and lipase) and also its macroelement composition: concentration of sodium, potassium, phosphorus, calcium, magnesium and chlorine using automatic biochemical analyzer «BioSystem A15» (Spain) according to the recommendations of the International Federation of Clinical Chemistry (IFCC) Experts Panel. The results of the introduction in the laboratory rats of drug-induced toxic hepatitis indicate a decrease of metabolic activity of hepatocytes under this hepatopathology. The results showed a decrease in total protein by 17%, albumin by 11%, glucose by 6% , triacylglycerols by 53%, cholesterol by 54%, and an appreciable increase in thymol test value (by a factor of 2.8). Besides this, disruption of the liver pigment function, development of cytolytic syndrome and intrahepatic cholestasis were revealed in the affected animals. The increased activity of the studied blood enzymes (ALT by 28%, AST by 45%, LP by 30%, GGT by a factor of 2.1) confirmed these disruptions. The increase in AST/ALT by 12% ratio confirmed destructive changes in cell membranes, including mitochondrial membranes, caused by metabolic changes under the toxic influence of sodium diclofenac. The increased activities of α-amylase by a factor of 2.4 and lipase by a factor of 8.3 indicate complex negative changes in the organism, not only in liver structure, but also in the pancreas. The results of the study indicate hypocalcemia (decrease by 29%), hypophosphatemia (decrease by 47%) and hypomagnesaemia (decrease by 38%) and a simultaneous increase in the Ca : P ratio by 35%. The last mentioned changes can cause the development of endogenous osteopathy. The results of the study can be used in diagnostics of development of hepatopathology caused by the toxic effects of medication on the liver, for prevention of complications through the early implementation of effective correction therapy.

show abstract

“…The common side effects of clindamycin are gastrointestinal including diarrhoea, vomiting, anorexia, flatulence, and pseudomembranous colitis caused by overgrowth of Clostridium difficile [1]. Though transient elevation of liver enzymes has been reported, there are few cases of acute idiosyncratic liver injury [1,3]. Here we present a patient who developed acute cholestatic hepatitis after receiving oral clindamycin for left lower limb cellulitis.…”

Section: Introductionmentioning

confidence: 99%

Possible cholestatic hepatitis with clindamycin therapy: A case report

Wettasinghe I.,

Samarasinghe S.M.,

Puthra S.

et al. 2023

jhsir

View full text Add to dashboard Cite

Introduction: Clindamycin is a lincosamide antibiotic that is effective against streptococci, staphylococci, and anaerobic bacteria. Though it predominantly undergoes hepatic metabolism, no dose adjustments are recommended for patients with hepatic dysfunction. Hepatotoxicity is a rare side effect and even though transient elevation of liver enzymes has been reported, there are very few cases of acute idiosyncratic liver injury. Case Presentation: A 49-year-old male from Sri Lanka, with no knowncomorbidities, was treated with oral clindamycin for left lower limb cellulitis. He was investigated for a low platelet count and was diagnosed to have chronic liver cell disease (CLCD) on day two of admission following an ultrasound scan of the liver. On day four of treatment, the patient developed deep icterus and asterixis. The serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels rose from normal levels to 681 U/L and 1100 U/L respectively. Total bilirubin had risen to 158.5 micromole/L with a high direct fraction of 116.1 micromole/L and alkaline phosphatase (ALP) was 108 U/L. Drug induced liver injury (DILI) was suspected immediately and clindamycin treatment was withheld. The patient’s symptoms improved over the next few days and the AST, ALT levels dropped immediately and returned to normal within three weeks. Serum anti-nuclear antibody and anti-mitochondrial antibody were negative. IgM antibodies for hepatitis A, C, E, and Epstein-Barr virus were negative and the test for hepatitis B surface antigen was negative. The serum ferritin and transferrin saturation were normal and there were no Kayser–Fleischer rings in the eyes. The urine toxicology screen was negative. Conclusion: This case highlights a rare but important complication of clindamycin treatment. Clinicians should be vigilant when starting clindamycin in a patient diagnosedor suspected to have CLCD and such patients should be monitored for DILI. Early recognition of DILI is essential and immediate discontinuation of drug is the most important intervention which alone can lead to resolution of the injury. Keywords: Clindamycin, Cholestasis, Hepatitis

show abstract

An Uncommon Complication of Commonly Used Medication

Cited by 4 publications

References 0 publications

Blood coagulation factors and platelet response to drug‐induced hepatitis and hepatosis in rats

Blood coagulation factors and platelet response to drug‐induced hepatitis and hepatosis in rats

Biochemical properties of the plasma of rats with the experimentally induced hepatitis after oral administration of sodium diclofenac

Possible cholestatic hepatitis with clindamycin therapy: A case report

Contact Info

Product

Resources

About