title: [Diclofenac-associated acute cholestatis hepatitis].
abstract: Diclofenac is an anti-inflammatory analgesic which is widely used in the therapy of inflammatory joint pain. Diclofenac hepatotoxicity ranges from asymptomatic elevation of transaminase activity to significant liver disease. 31 cases of diclofenac-induced hepatitis with five associated deaths have been already reported in the English, French and Spanish literature. We report the case of a 64-year-old patient who was admitted to the hospital with an icteric hepatitis of sudden onset. The only drug that was taken before admission was diclofenac in a daily dose of 150-200 mg because of a spondylodiscitis. Work-up of the patient included ERCP, laparoscopy and liver biopsy and excluded other reasons of a cholestatic hepatitis. Discontinuation of diclofenac resulted in normalization of transaminase activity and bilirubin concentration within four months. The frequent use of diclofenac and the possibility of fatal liver damage highlights the need that diclofenac-toxicity should be considered in the differential diagnosis of acute cholestatic hepatitis.
authors.affiliation: Klinik für Innere Medizin II, Universitätskliniken des Saarlandes
authors.forename: H
authors.initials: H
authors.lastname: Hackstein
authors.forename: W
authors.initials: W
authors.lastname: Mohl
authors.forename: W
authors.initials: W
authors.lastname: Püschel
authors.forename: A
authors.initials: A
authors.lastname: Stallmach
authors.forename: M
authors.initials: M
authors.lastname: Zeitz
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000009:adverse effects*; D001706:Biopsy; D056486:Chemical and Drug Induced Liver Injury / Q000175:diagnosis* / Q000473:pathology; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000175:diagnosis / Q000473:pathology; D003952:Diagnostic Imaging; D004008:Diclofenac / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy; D008099:Liver / Q000473:pathology; D008111:Liver Function Tests; D008297:Male; D008875:Middle Aged
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D004008:Diclofenac
vernacular_title: Diclofenac-assoziierte akute cholestatische Hepatitis.