AI Article Synopsis
- Drug-induced liver injury from trimethoprim sulfamethoxazole is rare and unpredictable, typically presenting as a mixed hepatocellular-cholestatic pattern.
- Two reported cases demonstrate severe, prolonged cholestasis, with symptoms like itching and abnormal liver tests persisting for 1-2 years post-treatment.
- Liver biopsies confirmed a cholestatic injury pattern with minimal damage to liver cells, emphasizing that prolonged cholestasis can occur even after discontinuation of the medication.
Article Abstract
Drug-induced liver injury due to trimethoprim sulfamethoxazole is rare and classified as an unpredictable or idiosyncratic type of hepatotoxic reaction. Early reports suggested that the pattern of liver injury in the majority of cases is mixed hepatocellular-cholestatic. The current report describes two cases of severe, prolonged cholestasis after treatment with trimethoprim sulfamethoxazole; intractable pruritus and abnormal liver test results lasted for 1-2 years after discontinuation of the drug. Liver biopsy specimens showed a cholestatic pattern of liver injury and only minimal hepatocellular necrosis or inflammation. Recent case reports suggest that cholestasis alone may occur after the use of trimethoprim sulfamethoxazole; these two additional cases show that cholestasis may be quite prolonged.
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| http://dx.doi.org/10.1016/0016-5085(92)90346-z | DOI Listing |
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