Acute hepatitis with prolonged cholestasis and disappearance of interlobular bile ducts following tibolone and Hypericum perforatum (St. John's wort). Case of drug interaction?
The case of a patient under tibolone therapy for two years who developed a mixed-type liver injury with prolonged cholestasis and features of the vanishing bile duct syndrome following a ten weeks treatment with St. John wort (Hypericum Perforatum) infusions is reported. In the absence of evidence of a potential role for concomitant medication i.e. hydroxychloroquine sulfate to play a role in the clinical, biochemical and morphological picture, an interaction between the herbal preparation and tibolone was suspected as the likely cause of liver damage.
Etogo-Asse
F
F
Department of Gastroenterology, Cliniques Universitaires St-Luc, Université Catholique de Louvain (UCL), Brussels, Belgium.
Boemer
F
F
Sempoux
C
C
Geubel
A
A
D000726:Androgen Antagonists / Q000009:adverse effects*; D001653:Bile Ducts, Intrahepatic / Q000187:drug effects* / Q000473:pathology; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D002779:Cholestasis / Q000139:chemically induced*; D004347:Drug Interactions; D005260:Female; D006801:Humans; D020902:Hypericum / Q000009:adverse effects*; D008875:Middle Aged; D009652:Norpregnenes / Q000009:adverse effects*; D017698:Postmenopause
D000726:Androgen Antagonists; D009652:Norpregnenes; C027385:tibolone