Antibiotic-associated acute vanishing bile duct syndrome: a pattern associated with severe, prolonged, intrahepatic cholestasis.
We report cases of amoxycillin- and flucloxacillin-induced liver damage associated with an acute vanishing bile duct syndrome. Ductopenia was present at the time of first liver biopsy, 3 weeks and 3 months after administration of the two drugs, respectively. Ductopenia apparently occurred as the primary lesion, with no evidence of accompanying portal tract inflammation. Subsequent biopsies showed a persistent paucity of ducts, accompanied by increasing features of chronic cholestasis. Biochemical dysfunction persists at 2 year's follow-up and late prognosis remains guarded.
Davies
M H
MH
Birmingham Liver Unit, Queen Elizabeth Hospital, Edgbaston, Birmingham, UK.
Harrison
R F
RF
Elias
E
E
Hübscher
S G
SG
D000038:Abscess / Q000188:drug therapy; D000328:Adult; D000658:Amoxicillin / Q000009:adverse effects* / Q000627:therapeutic use; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects*; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000473:pathology*; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D005436:Floxacillin / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D012141:Respiratory Tract Infections / Q000188:drug therapy
D005436:Floxacillin; D000658:Amoxicillin