title: Cholestatic jaundice associated with the use of metformin.
abstract: 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.
authors.affiliation: Department of Medicine, Walter Reed Army Medical Center, Washington, District of Columbia, USA.
authors.forename: D J
authors.initials: DJ
authors.lastname: Desilets
authors.forename: A F
authors.initials: AF
authors.lastname: Shorr
authors.forename: K A
authors.initials: KA
authors.lastname: Moran
authors.forename: K C
authors.initials: KC
authors.lastname: Holtzmuller
mesh_terms: 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
chemical_list: D008687:Metformin