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Norethisterone-induced cholestasis: A case report.

Safa Moussaoui1, Mehdi Abdelwahed1, Nabil Ben Chaaben1

  • 1Department of Gastroenterology Fattouma Bourguiba University Hospital of Monastir Tunisia.

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|March 14, 2022
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Summary
This summary is machine-generated.

Progestin-only pills containing norethisterone can cause liver injury, specifically cholestasis. Bile flow obstruction resolved after discontinuing these oral contraceptives.

Keywords:
cholestasiscontraceptive pillsnorethisteroneprogesteron

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Area of Science:

  • Hepatology
  • Pharmacology
  • Endocrinology

Background:

  • Progestin-only contraceptives are widely used for family planning.
  • Norethisterone is a common progestin used in oral contraceptives.
  • Drug-induced liver injury (DILI) is a potential adverse effect of medications.

Observation:

  • A 49-year-old woman presented with symptoms of cholestasis.
  • Cholestasis developed two and a half months after starting norethisterone-based progestin-only pills.
  • The patient's liver function tests indicated impaired bile flow.

Findings:

  • The cholestasis was directly linked to the initiation of norethisterone.
  • Discontinuation of the progestin-only pills led to the complete resolution of cholestasis.
  • This suggests a causal relationship between norethisterone and drug-induced cholestasis.

Implications:

  • Healthcare providers should be aware of the potential for norethisterone-induced cholestasis.
  • Monitoring liver function may be considered in patients on norethisterone, especially those with risk factors.
  • This case highlights the importance of considering medication side effects in the differential diagnosis of cholestasis.