Acute cholestatic hepatitis caused by amoxicillin/ clavulanate  

作　　者：Daniel Oliveira Beraldo Joanderson Fernandes Melo Alexandre Vidal Bonfim Andrei Alkmim Teixeira Ricardo Alkmim Teixeira André Loyola Duarte 

机构地区：[1]Department of Internal Medicine,Hospital Renascentista [2]Escola Paulista de Medicina-UNIFESP,Nephrology Department [3]Escola Paulista de Medicina-UNIFESP,Cardiology Department [4]Cardiology Department,Instituto do Cora o-FMUSP [5]Pathology Department,Hospital A.C.Camargo,So Paulo

出　　处：《World Journal of Gastroenterology》2013年第46期8789-8792,共4页世界胃肠病学杂志（英文版）

摘　　要：Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used,especially for the treatment of respiratory and cutaneous infections.In general,it is a well-tolerated oral antibiotic.However,amoxicillin/clavulanate can cause adverse effects,mainly cutaneous,gastrointestinal,hepatic and hematologic,in some cases.Presented here is a case report of a 63-yearold male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate.After 6 wk of prolonged use of the drug,he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia(total bilirubin>300 mg/L).Diagnostic investigation was conducted by ultrasonography of the upper abdomen,serum tests for infection history,laboratory screening of autoimmune diseases,nuclear magnetic resonance(NMR)of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound.The duration of disease was approximately 4 mo,with complete resolution of symptoms and laboratory changes at the end of that time period.Specific treatment was not instituted,only a combination of anti-emetic(metoclopramide)and cholestyramine for pruritus.Amoxicillin/clavulanate is a synthetic penicillin that is currently commonly used, especially for the treatment of respiratory and cutaneous infections. In general, it is a well-tolerated oral antibiotic. However, amoxicillin/clavulanate can cause adverse effects, mainly cutaneous, gastrointestinal, hepatic and hematologic, in some cases. Presented here is a case report of a 63-year-old male patient who developed cholestatic hepatitis after recent use of amoxicillin/clavulanate. After 6 wk of prolonged use of the drug, he began to show signs of cholestatic icterus and developed severe hyperbilirubinemia (total bilirubin > 300 mg/L). Diagnostic investigation was conducted by ultrasonography of the upper abdomen, serum tests for infection history, laboratory screening of autoimmune diseases, nuclear magnetic resonance (NMR) of the abdomen with bile duct-NMR and transcutaneous liver biopsy guided by ultrasound. The duration of disease was approximately 4 mo, with complete resolution of symptoms and laboratory changes at the end of that time period. Specific treatment was not instituted, only a combination of anti-emetic (metoclopramide) and cholestyramine for pruritus.

关 键 词：HEPATOLOGY HEPATITIS Amoxicillin/Clavula-nate Drug REACTIONS HYPERBILIRUBINEMIA 

分 类 号：R575.1[医药卫生—消化系统]