Nature clinical practice. Gastroenterology & hepatology · 2007
Drug-induced acute cholestatic liver damage in a patient with mutation of UGT1A1.
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Rigato Igino, Cravatari Monica, Avellini Claudio, Ponte Euro, Crocè Saveria Lory, Tiribelli Claudio
Аннотация
BACKGROUND: A 54-year-old woman presented with a 3-week history of fatigue and with jaundice that began 2 days before admission. She had been undergoing treatment with flavoxate for urinary incontinence (for 2 months before admission) and with tibolone for climacteric syndrome (for 6 months before admission). Laboratory tests revealed elevated concentrations of aminotransferases, bilirubin, gamma-glutamyltransferase and alkaline phosphatase. Liver biopsy revealed histological evidence of subacute, drug-induced liver damage.
INVESTIGATIONS: Physical examination, liver function tests, serology tests, autoantibody tests, genetic analysis of the TATA box of the UGT1A1 gene, ultrasonography and CT scan; MRI cholangiography; liver biopsy.
DIAGNOSIS: Drug-related hepatitis in a patient with Gilbert's syndrome.
MANAGEMENT: Flavoxate and tibolone were discontinued. Liver function test results improved progressively and normalized after almost 2 months.
INVESTIGATIONS: Physical examination, liver function tests, serology tests, autoantibody tests, genetic analysis of the TATA box of the UGT1A1 gene, ultrasonography and CT scan; MRI cholangiography; liver biopsy.
DIAGNOSIS: Drug-related hepatitis in a patient with Gilbert's syndrome.
MANAGEMENT: Flavoxate and tibolone were discontinued. Liver function test results improved progressively and normalized after almost 2 months.