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Reversible cholestatic hepatitis caused by acetohexamide
Gastroenterology
|June 1, 1989
Summary
Acetohexamide use can cause cholestatic hepatitis with eosinophilia. Discontinuing the drug led to rapid recovery, normalizing liver function and eosinophil counts.
Area of Science:
- Hepatology
- Clinical Pharmacology
Background:
- Drug-induced liver injury (DILI) is a significant concern in clinical practice.
- Cholestatic hepatitis is a pattern of liver damage characterized by impaired bile flow.
- Eosinophilia, an increase in eosinophils, can be associated with various conditions, including drug reactions.
Observation:
- A patient developed acute cholestatic hepatitis and jaundice, accompanied by fever and elevated eosinophil levels in the blood and liver.
- The patient had been taking acetohexamide, an oral hypoglycemic agent, for 1.5 years.
- Symptoms appeared acutely after a prolonged period of drug exposure.
Findings:
- Discontinuation of acetohexamide resulted in the complete resolution of liver damage.
- Liver enzymes, bilirubin levels, and peripheral eosinophil counts promptly normalized after drug withdrawal.
- Histopathological evidence of hepatic eosinophilia also resolved.
Implications:
- This case highlights acetohexamide as a potential cause of drug-induced cholestatic hepatitis with eosinophilia.
- Early recognition and drug discontinuation are crucial for favorable outcomes in DILI.
- Monitoring liver function and eosinophil counts may be warranted in patients on long-term acetohexamide therapy.
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