Severe cholestatic jaundice associated with piroxicam.
A 62-year-old man with rheumatoid arthritis developed jaundice while taking piroxicam. A full evaluation including ultrasound, computerized tomography, endoscopic cholangiography, and liver biopsy confirmed the diagnosis of intrahepatic cholestasis. The patient's jaundice and all other liver function abnormalities normalized 4 months after he discontinued taking piroxicam. This is the first case report in the United States of severe liver toxicity associated with piroxicam. The six cases in the English-language literature are reviewed, featuring the presentation, patterns of liver injury, and outcome in each. Piroxicam should be considered as a potential cause of cholestatic jaundice when other more common etiologies have been excluded.
Hepps
K S
KS
Department of Medicine, Baylor College of Medicine, Houston, Texas.
Maliha
G M
GM
Estrada
R
R
Goodgame
R W
RW
D001706:Biopsy; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000473:pathology; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010894:Piroxicam / Q000009:adverse effects*
D010894:Piroxicam