Related Experiment Videos
Hepatic injury in a child caused by trimethoprim-sulfamethoxazole
Pediatrics
|June 1, 1978
Insights
Trimethoprim-sulfamethoxazole can cause severe cholestatic hepatitis, a liver injury, in adolescents. This case suggests an indirect hypersensitivity reaction to sulfamethoxazole may be the cause.
Area of Science:
- Hepatology
- Pharmacology
- Immunology
Background:
- Urinary tract infections (UTIs) are common in adolescents.
- Prophylaxis with antibiotics like trimethoprim-sulfamethoxazole is sometimes used.
- Adverse drug reactions can occur even with prophylactic antibiotic use.
Observation:
- A 16-year-old male developed severe cholestatic hepatitis 41 days after starting trimethoprim-sulfamethoxazole for UTI prophylaxis.
- Liver biopsy revealed portal inflammation and significant bile stasis.
- The patient's presentation was consistent with a drug-induced liver injury.
Findings:
- The clinical presentation and biopsy findings support a diagnosis of drug-induced cholestatic hepatitis.
- The reaction pattern suggests an indirect hypersensitivity mechanism.
- Sulfamethoxazole is implicated as the likely causative agent.
Implications:
- This case highlights the potential for severe hepatic adverse events from trimethoprim-sulfamethoxazole in adolescents.
- It underscores the importance of considering drug-induced liver injury in patients presenting with hepatitis after antibiotic exposure.
- Further investigation into hypersensitivity reactions to sulfonamides may be warranted.
Abstract:
Trimethoprim-sulfamethoxazole was given to a 16-year-old boy as prophylaxis for a urinary tract infection. He developed severe cholestatic hepatitis 41 days after administration of the drug. A liver biopsy specimen showed a mixed inflammatory infiltrate in the portal triads and prominent bile stasis. The clinical course in this patient supports the concept of an indirect hypersensitivity reaction to sulfamethoxazole.