Cholestatic jaundice associated with the use of metformin.
We report a patient who developed cholestatic jaundice shortly after initiation of treatment with metformin hydrochloride. Ultrasound of the liver and abdominal CT were normal. An ERCP showed normal biliary anatomy. A percutaneous liver biopsy was obtained showing marked cholestasis, with portal edema, ductular proliferation, and acute inflammation. Metformin hydrochloride was discontinued, and the patient's jaundice resolved slowly over a period of several months. Given the onset of his jaundice 2 wk after the initiation of metformin, we believe that this case represents an example of metformin-associated hepatotoxicity, the first such case reported.
Desilets
D J
DJ
Department of Medicine, Walter Reed Army Medical Center, Washington, District of Columbia, USA.
Shorr
A F
AF
Moran
K A
KA
Holtzmuller
K C
KC
D002760:Cholangiopancreatography, Endoscopic Retrograde; D002779:Cholestasis / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D008111:Liver Function Tests; D008297:Male; D008687:Metformin / Q000009:adverse effects*; D008875:Middle Aged
D008687:Metformin