title: Liver injury related to amoxycillin-clavulanic acid: interlobular bile-duct lesions and extrahepatic manifestations.
abstract: We report eight cases of liver injury related to amoxycillin-clavulanate. Liver biopsy performed in seven patients revealed varying degrees of injury to interlobular bile ducts in all cases. Lesions included irregularity of the nuclei, vacuolization of the cytoplasm, lymphocytic infiltration, destruction and endothelialization of the bile duct epithelium. Ductopenia was not observed. In two patients liver injury was accompanied by prominent extrahepatic manifestations (acute interstitial nephritis in one and acute lacrimal gland inflammation and sialadenitis with prolonged xerostomia in the other). We conclude that interlobular bile-duct lesions of varying severity are a common feature in liver injury related to amoxycillin-clavulanate. Side effects of the drug include acute interstitial nephritis and sialadenitis.
authors.affiliation: Middelheim Hospital, Antwerp, Belgium.
authors.forename: M L
authors.initials: ML
authors.lastname: Hautekeete
authors.forename: R
authors.initials: R
authors.lastname: Brenard
authors.forename: Y
authors.initials: Y
authors.lastname: Horsmans
authors.forename: J
authors.initials: J
authors.lastname: Henrion
authors.forename: L
authors.initials: L
authors.lastname: Verbist
authors.forename: G
authors.initials: G
authors.lastname: Derue
authors.forename: P
authors.initials: P
authors.lastname: Druez
authors.forename: M
authors.initials: M
authors.lastname: Omar
authors.forename: M
authors.initials: M
authors.lastname: Kockx
authors.forename: H
authors.initials: H
authors.lastname: Hubens
mesh_terms: D000368:Aged; D000658:Amoxicillin / Q000009:adverse effects; D019980:Amoxicillin-Potassium Clavulanate Combination; D001653:Bile Ducts, Intrahepatic / Q000473:pathology*; D056486:Chemical and Drug Induced Liver Injury; D002969:Clavulanic Acids / Q000009:adverse effects; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007249:Inflammation; D007766:Lacrimal Apparatus Diseases / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009395:Nephritis, Interstitial / Q000139:chemically induced; D012793:Sialadenitis / Q000139:chemically induced; D014987:Xerostomia / Q000139:chemically induced
chemical_list: D002969:Clavulanic Acids; D019980:Amoxicillin-Potassium Clavulanate Combination; D000658:Amoxicillin