Amaro P, Nunes A, Maçôas F, Ministro P, Baranda J, Cipriano A, Martins I, Rosa A, Pimenta I, Donato A, Freitas D
Department of Gastroenterology, Coimbra University Hospital, Portugal.
Eur J Gastroenterol Hepatol. 1999 Jun;11(6):673-6. doi: 10.1097/00042737-199906000-00015.
We report a case of ticlopidine-induced prolonged cholestasis in a 60-year-old man with no previous hepatobiliary disease who presented with sudden right upper abdominal pain, jaundice and pruritus three months after starting ticlopidine therapy. Other drugs taken by the patient were not considered probable causes. The diagnostic evaluation showed no biliary obstruction and other possible causes of intra-hepatic cholestasis were excluded. The liver biopsy showed a cholestatic hepatitis with bile duct damage. The disease ran a severe and protracted course, but symptoms and jaundice eventually subsided five months after drug withdrawal. More than a year later, relevant abnormalities of liver function tests consistent with anicteric cholestasis still persist, fulfilling criteria for a minor form of drug-induced prolonged cholestasis. This syndrome has been reported infrequently in relation to several drugs, mainly chlorpromazine, and only once with ticlopidine.
我们报告一例噻氯匹定诱发的长期胆汁淤积病例，患者为一名60岁男性，既往无肝胆疾病，在开始噻氯匹定治疗三个月后出现右上腹突发疼痛、黄疸和瘙痒。患者服用的其他药物不被认为是可能的病因。诊断评估显示无胆道梗阻，且排除了肝内胆汁淤积的其他可能病因。肝活检显示为伴有胆管损伤的胆汁淤积性肝炎。该病病程严重且迁延，但停药五个月后症状和黄疸最终消退。一年多后，仍存在与无黄疸型胆汁淤积相符的肝功能检查相关异常，符合轻度药物诱发的长期胆汁淤积标准。关于几种药物，主要是氯丙嗪，这种综合征鲜有报道，而与噻氯匹定相关的仅报道过一次。
