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[Ticlopidine-induced acute cholestatic hepatitis]

C Wegmann¹, R Münzenmaier, A J Dormann

¹Medizinische Klinik, Klinikum Minden.

Deutsche Medizinische Wochenschrift (1946)

|March 20, 1998

Summary

Ticlopidine, a platelet inhibitor, can cause toxic liver damage, presenting as cholestatic hepatitis. This adverse effect, characterized by jaundice and elevated liver enzymes, necessitates medical attention and drug discontinuation.

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Area of Science:

Hepatology
Clinical Pharmacology
Toxicology

Background:

Ticlopidine is a platelet aggregation inhibitor used to prevent thrombotic events.
Cerebellar infarct patients may be prescribed ticlopidine for secondary prevention.

Observation:

A 52-year-old male developed pruritus, malaise, diarrhea, dark urine, and jaundice 28 days after initiating ticlopidine.
Physical exam revealed jaundice and excoriations; lab tests showed elevated alkaline phosphatase, gamma-GT, and bilirubin, with mild GPT/GOT increases.
Liver biopsy indicated centro-acinar cholestasis, suggesting drug-induced liver injury.

Findings:

The patient presented with symptoms and laboratory findings consistent with cholestatic hepatitis.
Hepatobiliary dysfunction resolved 2.5 months after ticlopidine cessation.

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No other causes for cholestasis were identified.

Implications:

Ticlopidine can induce significant hepatotoxicity, including cholestatic liver injury.
Clinicians should monitor for liver function abnormalities in patients taking ticlopidine.
Awareness of ticlopidine's potential for liver damage is crucial given its widespread use.