Fosinopril-induced prolonged cholestatic jaundice and pruritus: first case report.
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.
Nunes
A C
AC
Department of Gastroenterology, Coimbra University Hospital, Portugal. ascrnunes@hotmail.com
Amaro
P
P
Maç as
F
F
Cipriano
A
A
Martins
I
I
Rosa
A
A
Pimenta
I
I
Donato
A
A
Freitas
D
D
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*
D000806:Angiotensin-Converting Enzyme Inhibitors; D017328:Fosinopril