Prolonged cholestasis and disappearance of interlobular bile ducts following chlorpropamide and erythromycin ethylsuccinate. Case of drug interaction?
A 52-year-old man, having been treated for 4 months with chlorpropamide for diabetes mellitus type II, developed severe cholestatic hepatitis following a short course of erythromycin ethylsuccinate. Despite prompt withdrawal of both drugs, the cholestatic picture worsened and was associated with morphological evidence of disappearing interlobular bile ducts. After a 2-year course of profound cholestasis complicated by steatorrhea and striking hyperlipidemia, the patient died of ischemic cardiomyopathy. It is believed that this is the first published case of irreversible cholestasis with disappearance of ducts potentially related to a metabolic interaction between erythromycin ethylsuccinate and chlorpropamide.
Geubel
A P
AP
Department of Gastroenterology, St. Luc University Hospital, Bruxelles, Belgium.
Nakad
A
A
Rahier
J
J
Dive
C
C
D001653:Bile Ducts, Intrahepatic / Q000187:drug effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002747:Chlorpropamide / Q000009:adverse effects* / Q000627:therapeutic use; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced*; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy; D004347:Drug Interactions; D004917:Erythromycin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D015643:Erythromycin Ethylsuccinate; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors
D015643:Erythromycin Ethylsuccinate; D004917:Erythromycin; D002747:Chlorpropamide