title: Terbinafine-induced prolonged cholestasis with reduction of interlobular bile ducts.
abstract: The antifungal drug terbinafine has infrequently been incriminated in the occurrence of acute liver injury. We report a case of prolonged cholestasis that occurred in a 75-year-old woman, following terbinafine administration. Jaundice followed by pruritus appeared after four weeks of therapy and was associated with mixed hepatocellular and cholestatic liver tests abnormalities. Following drug withdrawal, serum bilirubin returned to normal values within three months, but anicteric cholestasis persisted for over six months. A liver biopsy performed after six months showed centrilobular cholestasis, discrete portal fibrosis, and a reduction in the number of interlobular biliary ducts. Terbinafine should be added to the list of drugs that can cause reduction in interlobular bile ducts.
authors.affiliation: Service d'Hépatologie et de Gastroentérologie, Hôpital Henri Mondor, Créteil, France.
authors.forename: A
authors.initials: A
authors.lastname: Mallat
authors.forename: E S
authors.initials: ES
authors.lastname: Zafrani
authors.forename: J M
authors.initials: JM
authors.lastname: Metreau
authors.forename: D
authors.initials: D
authors.lastname: Dhumeaux
mesh_terms: D000368:Aged; D000935:Antifungal Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects / Q000473:pathology; D002179:Candidiasis, Cutaneous / Q000188:drug therapy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis / Q000209:etiology*; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000175:diagnosis; D005260:Female; D006801:Humans; D009281:Naphthalenes / Q000009:adverse effects* / Q000627:therapeutic use; D000077291:Terbinafine
chemical_list: D000935:Antifungal Agents; D009281:Naphthalenes; D000077291:Terbinafine