[Cholestatic hepatitis. Presumptive role of ticlopidine]

A seventy-one-year-old woman presented with jaundice (total bilirubinemia 91 microM, conjugated bilirubinemia 76 microM) and cytolysis (ALAT greater than 6 N) after ten days of pentoxifylline-ticlopidine combination therapy. Blood count was normal excepting transient anemia. Protein electrophoresis was normal. Jaundice resolved 10 days after both drugs had been discontinued. Viral serology (B, A, nonA-nonB, mononucleosis, cytomegalovirus, herpes simplex virus) was negative. Ultrasonography and cholecystography were normal. Responsibility of a drug is therefore likely and we are inclined to incriminate ticlopidine as two similar cases have previously been observed.