Captopril-associated cholestatic jaundice.
Captopril, the competitive inhibitor of angiotensin-converting enzyme, is of considerable benefit in difficult-to-manage forms of hypertension. Its use has been associated with various untoward effects, but hepatic injury has not been widely reported. We treated a patient with captopril-associated cholestatic jaundice; a review of cases reported to the drug manufacturer and a review of the literature showed 13 additional cases of hepatic injury associated with captopril. In 9 of these the jaundice was categorized as cholestatic, and in 4 of the remaining 5 as mixed cholestatic-hepatocellular. These findings show that jaundice may be an idiosyncratic side effect of captopril, and that captopril-associated jaundice characteristically has strongly cholestatic features.
D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001663:Bilirubin / Q000097:blood; D002216:Captopril / Q000009:adverse effects*; D002780:Cholestasis, Intrahepatic / Q000097:blood / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011392:Proline / Q000031:analogs & derivatives*; D011537:Pruritus / Q000139:chemically induced
D011392:Proline; D002216:Captopril; D001219:Aspartate Aminotransferases; D000469:Alkaline Phosphatase; D001663:Bilirubin