Cholestatic and hepatocellular injury associated with erythromycin esters: report of nine cases.

A combined cholestatic and hepatocellular injury occurred in nine patients, following therapy with erythromycin estolate (EE) or other erythromycin derivatives. Eight of the nine patients developed jaundice within three weeks after initiation of treatment; pain was one of the main symptoms in five patients while fever and itching were noted in four patients. Symptoms and signs subsided and abnormal tests of liver function returned to normal after withdrawal of the drug.

Hypersensitivity reaction to sulfasalazine with severe hepatotoxicity.

Sulfasalazine hepatotoxicity has been poorly documented in the literature. We report a case of a young female with inflammatory bowel disease who developed severe hepatotoxicity as part of a systemic hypersensitivity reaction to sulfasalazine. The clinical, biochemical, and histopathological features resemble those of sulfonamide-induced hepatic injury.

Chronic intrahepatic cholestasis of sarcoidosis.

The development of the syndrome of chronic intrahepatic cholestasis in five young, black men who had systemic granulomatous disease and clinical features consistent with those of sarcoidosis is described. Clinical and biochemical aspects, similar to those of primary biliary cirrhosis, included pruritus, jaundice, hepatomegaly and striking elevations of serum levels of alkaline phosphatase and cholesterol. (One patient had skin xanthomas.