Granulomatous hepatitis due to combination of amoxicillin and clavulanic acid.
We report the case of a patient with amoxicillin-clavulanic acid-induced hepatitis with histologic multiple granulomas. This type of lesion broadens the spectrum of liver injury due to this drug combination, mainly represented by a benign cholestatic syndrome. The association of granulomas and eosinophilia favor an immunoallergic mechanism. As penicillin derivatives and amoxicillin alone are known to induce such types of lesions, the amoxicillin component, with or without a potentiating effect of clavulanic acid, might have a major role.
Silvain
C
C
Service d'Hépato-Gastro-Entérologie, CHU la Milétrie, Poitiers, France.
Fort
E
E
Levillain
P
P
Labat-Labourdette
J
J
Beauchant
M
M
D000368:Aged; D000658:Amoxicillin / Q000009:adverse effects*; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000473:pathology; D019818:Clavulanic Acid; D002969:Clavulanic Acids / Q000009:adverse effects*; D004338:Drug Combinations; D006099:Granuloma / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology; D008297:Male
D000900:Anti-Bacterial Agents; D002969:Clavulanic Acids; D004338:Drug Combinations; D019818:Clavulanic Acid; D000658:Amoxicillin