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Published on: October 21, 2017
Acute hepatocellular and cholestatic injury during therapy with hydrochlorothiazide - clinicohistopathologic
Fabrizio Taglietti1, Franca Del Nonno, Andrea Baiocchini
1II Division of Infectious Diseases, Istituto Nazionale per le Malattie Infettive, Istituto di Ricovero e Cura a Carattere Scientifico 'Lazzaro Spallanzani', Rome, Italy. taglietti.f@gmail.com.
Introduction:
Hydrochlorothiazide and thiazide-like diuretics are considered first-line drugs for initial therapy in uncomplicated arterial hypertension. Acute cholecystitis is a well-known complication during treatment with thiazide, and these drugs are also reported to be followed by pronounced insulin resistance.
Case Presentation:
We describe a case of acute cholestatic hepatitis in a 68-year-old Caucasian man who was receiving olmesartan and hydrochlorothiazide for arterial hypertension. From the clinical and histologic findings, we diagnosed him as having hepatocellular-cholestatic injury and a disorder of glucose metabolism in the liver. To the best of our knowledge, no histopathologic description of hydrochlorothiazide hepatotoxicity has previously been documented in the literature.
Conclusion:
In the differential diagnosis of cholestatic hepatitis, clinicians should be aware of the possibility of liver damage in patients receiving hydrochlorothiazide therapy.
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