title: Candesartan cilexetil-induced severe hepatotoxicity.
abstract: We report a case of severe hepatotoxicity associated with ductopenia in a 61-year-old woman. The patient developed jaundice, vomiting, and abdominal pain a few weeks after the beginning of treatment with candesartan cilexetil, 16 mg/d, for essential hypertension. Liver biopsy showed parenchymal bilirubinostasis with portal cholangitis and ductopenia. The drug was immediately withdrawn, and in the following weeks, aminotransferases and serum bilirubin returned to normal levels. The clinical-histologic data and the exclusion of known causes of liver disease led us to make a diagnosis of drug-induced cholestasis. To our knowledge, this is the first description of severe hepatotoxicity associated with ductopenia caused by an adverse reaction to candesartan cilexetil.
authors.affiliation: Division of Geriatric Medicine, Department of Internal Medicine, University of Messina, Messina, Italy. gior.basile@tiscalinet.it
authors.forename: Giorgio
authors.initials: G
authors.lastname: Basile
authors.forename: Daniela
authors.initials: D
authors.lastname: Villari
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Gangemi
authors.forename: Tiziana
authors.initials: T
authors.lastname: Ferrara
authors.forename: Maria G
authors.initials: MG
authors.lastname: Accetta
authors.forename: Vittorio
authors.initials: V
authors.lastname: Nicita-Mauro
mesh_terms: D000959:Antihypertensive Agents / Q000009:adverse effects*; D001562:Benzimidazoles / Q000009:adverse effects*; D001713:Biphenyl Compounds / Q000009:adverse effects*; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced* / Q000473:pathology; D005260:Female; D006801:Humans; D008099:Liver / Q000187:drug effects*; D008875:Middle Aged; D011168:Portal System / Q000473:pathology; D013777:Tetrazoles
chemical_list: D000959:Antihypertensive Agents; D001562:Benzimidazoles; D001713:Biphenyl Compounds; D013777:Tetrazoles; C077793:candesartan cilexetil