Intrahepatic cholestasis induced by phenylbutazone

Digestion
J P van de MerweJ H Wilson

Abstract

The case history of a woman with intrahepatic cholestasis is described. She had taken phenylbutazone during 1 month for painful swollen knees. A liver biopsy obtained at surgical exploration revealed pericentral cholestasis and infiltration of the portal spaces with lymphocytes and eosinophilic leucocytes, suggesting a drug reaction. Clinical and biochemical parameters returned to normal within 2 months. A provocation test with a single dose of phenylbutazone was performed 6 months after her recovery. On the 2nd day, a marked increase of serum transaminases and alkaline phosphatase was observed. Transaminases became normal within several days, whereas alkaline phosphatase remained elevated during a month. From these data we conclude that phenylbutazone can cause cholestatic jaundice probably as a result of a hypersensitivity reaction.

Citations

Apr 1, 1988·Baillière's Clinical Gastroenterology·D Larrey, S Erlinger
Jan 1, 1992·Drug Metabolism and Drug Interactions·G Feuer, C J Di Fonzo

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