title: Fosinopril-induced prolonged cholestatic jaundice and pruritus: first case report.
abstract: We report a case of fosinopril-induced prolonged cholestatic jaundice and pruritus in a 61-year-old man, with no previous hepatobiliary disease, who presented with asthenia, jaundice and itching 3 weeks after starting fosinopril therapy. Other drugs taken by the patient were not considered probable causes. The diagnostic evaluation showed no biliary obstruction and other possible causes of intra-hepatic cholestasis were excluded. Liver biopsy showed cholestasis without bile duct damage. The disease ran a severe course during the 2 months of hospitalization, with prolonged itching for 6 months, eventually controlled with oral naltrexone. Jaundice subsided after 4 months, with anicteric cholestasis persisting for more than 18 months. Similar occurrences have been reported with other inhibitors of angiotensin-converting enzyme (mostly captopril), but this is the first case of an important adverse reaction to fosinopril.
authors: Department of Gastroenterology, Coimbra University Hospital, Portugal. ascrnunes@hotmail.com
authors: A C
authors: AC
authors: Nunes
authors: P
authors: P
authors: Amaro
authors: F
authors: F
authors: Maç as
authors: A
authors: A
authors: Cipriano
authors: I
authors: I
authors: Martins
authors: A
authors: A
authors: Rosa
authors: I
authors: I
authors: Pimenta
authors: A
authors: A
authors: Donato
authors: D
authors: D
authors: Freitas
mesh_terms: D000806:Angiotensin-Converting Enzyme Inhibitors / Q000009:adverse effects*; D002779:Cholestasis / Q000139:chemically induced*; D017328:Fosinopril / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011537:Pruritus / Q000139:chemically induced*
chemical_list: D000806:Angiotensin-Converting Enzyme Inhibitors; D017328:Fosinopril