Acute cholestatic hepatitis caused by amoxicillin/clavulanate

• Autor(a) principal: Beraldo, Daniel Oliveira [UNIFESP]
• Data de Publicação: 2013
• Outros Autores: Melo, Joanderson Fernandes, Bonfim, Alexandre Vidal [UNIFESP], Teixeira, Andrei Alkmim [UNIFESP], Teixeira, Ricardo Alkmim, Duarte, Andre Loyola
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.3748/wjg.v19.i46.8789; http://repositorio.unifesp.br/handle/11600/37081
• topic: Hepatology; Hepatitis; Amoxicillin/Clavulanate; Drug reactions; Hyperbilirubinemia

Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used, especially for the treatment of respiratory and cutaneous infections. in general, it is a well-tolerated oral antibiotic. However, amoxicillin/clavulanate can cause adverse effects, mainly cutaneous, gastrointestinal, hepatic and hematologic, in some cases. Presented here is a case report of a 63-year-old male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate. After 6 wk of prolonged use of the drug, he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia (total bilirubin > 300 mg/L). Diagnostic investigation was conducted by ultrasonography of the upper abdomen, serum tests for infection history, laboratory screening of autoimmune diseases, nuclear magnetic resonance (NMR) of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound. the duration of disease was approximately 4 mo, with complete resolution of symptoms and laboratory changes at the end of that time period. Specific treatment was not instituted, only a combination of anti-emetic (metoclopramide) and cholestyramine for pruritus. (C) 2013 Baishideng Publishing Group Co., Limited. All rights reserved.