Severe hepatitis with prolonged cholestasis and bile duct injury due the long-term use of ornidazole.
Nitroimidazole derivatives are commonly used in the treatment of protozoal and anaerobic infections, and reports of their hepatotoxicity are rare. We report a case of severe hepatitis due to the long-term (8 weeks) use of ornidazole. A 27-year-old woman presented for evaluation of elevated serum transaminase and total bilirubin levels. Liver biopsy revealed portal inflammation, hepatocellular and canalicular cholestasis, porto-portal and portocentral bridging fibrosis, and a tendency to form nodules. No aetiological factors associated with chronic liver disease were identified. The abdominal ultrasonographic findings were compatible with chronic liver disease. We therefore made the diagnosis of severe hepatitis resulting from the long-term use of ornidazole. We conclude that nitroimidazole derivatives may lead to serious liver damage, especially in female patients.
Harputluoglu
Murat Muhsin Muhip
MM
Department of Gastroenterology, Inonu University Medical Faculty, Malatya, Turkey. mharputluoglu@hotmail.com
Demirel
U
U
Karadag
N
N
Karahan
D
D
Aladag
M
M
Karincaoglu
M
M
Hilmioglu
F
F
D000328:Adult; D000563:Amebicides / Q000009:adverse effects*; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002780:Cholestasis, Intrahepatic / Q000139:chemically induced*; D005260:Female; D005500:Follow-Up Studies; D006529:Hepatomegaly / Q000139:chemically induced; D006801:Humans; D007565:Jaundice / Q000139:chemically induced; D008103:Liver Cirrhosis / Q000139:chemically induced; D009950:Ornidazole / Q000009:adverse effects*
D000563:Amebicides; D009950:Ornidazole