[Late-appearing cholestatic icterus after a month of treatment with ticlopidine].
A 65-year-old man was submitted to coronary angioplasty and stent implantation for stable angina. The treatment included a 30-day therapy with ticlopidine (in addition to aspirin, metoprolol, ramipril, amlodipine and nitrates). One month after ticlopidine withdrawal a progressive cholestatic jaundice took place. Viral, immunogenic as well as nutritional causes were ruled out. The abdominal echography disclosed a normal biliary tree and the liver biopsy showed a centrolobular cholestasis pattern. Drug-induced cholestatic reaction was diagnosed and attributed to ticlopidine. There was a progressive improvement in clinical and laboratory findings 4 months after steroid treatment. The clinical picture was normalized after 6 months. When considering the option ticlopidine, even for a short time after coronary angioplasty, the possibility of drug-induced hepatotoxicity should be kept in mind. Consequently, markers of liver toxicity should be monitored carefully.
Placci
A
A
Istituto di Cardiologia, Università degli Studi Policlinico S. Orsola-Malpighi Via Massarenti, 9 40138 Bologna.
Melandri
G
G
Cecilioni
L
L
Valgimigli
M
M
Bolondi
L
L
Branzi
A
A
D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology; D023921:Coronary Stenosis / Q000628:therapy; D006801:Humans; D007565:Jaundice / Q000139:chemically induced*; D008297:Male; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D015607:Stents; D013988:Ticlopidine / Q000009:adverse effects* / Q000627:therapeutic use; D013997:Time Factors
D010975:Platelet Aggregation Inhibitors; D013988:Ticlopidine
Ittero colestatico a comparsa ritardata dopo trattamento per un mese con ticlopidina.