Browse > Article
http://dx.doi.org/10.5223/pghn.2013.16.4.273

Urosodeoxycholic Acid Therapy in a Child with Trimethoprim- Sulfamethoxazole-induced Vanishing Bile Duct Syndrome  

Cho, Hyun Jeong (Department of Pediatrics, Chungnam National University School of Medicine)
Jwa, Hye Jeong (Department of Pediatrics, Chungnam National University School of Medicine)
Kim, Kyu Seon (Department of Pediatrics, Chungnam National University School of Medicine)
Gang, Dae Yong (Department of Pathology, Chungnam National University School of Medicine)
Kim, Jae Young (Department of Pediatrics, Chungnam National University School of Medicine)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.16, no.4, 2013 , pp. 273-278 More about this Journal
Abstract
We present a case of a 7-year-old boy who had cholestasis after trimethoprim-sulfamethoxazole combination therapy. Liver biopsy was performed 36 days after the onset of jaundice because of no evidence of improving cholestasis. Liver histology revealed portal inflammation, bile plug, and biliary stasis around the central vein with the loss of the interlobular bile ducts. Immunohistochemical stains for cytokeratin 7 and 19 were negative. These findings were consistent with those of vanishing bile duct syndrome (VBDS). Chlestasis was progressively improved with dose increment of urosodeoxycholic acid from conventional to high dose. This is the first case report of trimethoprime-sulfamethoxazole associated VBDS in Korean children. The case suggests that differential diagnosis of VBDS should be considered in case of progressive cholestatic hepatitis with elevation of alkaline phosphatase and gamma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.
Keywords
Cholestasis; Trimethoprim-sulfamethoxazole combination;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Faria LC, Resende CC, Couto CA, Couto OF, Fonseca LP, Ferrari TC. Severe and prolonged cholestasis caused by trimethoprim-sulfamethoxazole: a case report. Clinics (Sao Paulo) 2009;64:71-4.   DOI   ScienceOn
2 Nakanuma Y, Tsuneyama K, Harada K. Pathology and pathogenesis of intrahepatic bile duct loss. J Hepatobiliary Pancreat Surg 2001;8:303-15.   DOI
3 Abusin S, Johnson S. Sulfamethoxazole/trimethoprim induced liver failure: a case report. Cases J 2008;1:44.   DOI   ScienceOn
4 Yao F, Behling CA, Saab S, Li S, Hart M, Lyche KD. Trimethoprim-sulfamethoxazole-induced vanishing bile duct syndrome. Am J Gastroenterol 1997;92:167-9.
5 Pusl T, Beuers U. Ursodeoxycholic acid treatment of vanishing bile duct syndromes. World J Gastroenterol 2006;12:3487-95.   DOI
6 Desmet VJ. Vanishing bile duct syndrome in drug-induced liver disease. J Hepatol 1997;26(Suppl 1):31-5.
7 Smith LA, Ignacio JR, Winesett MP, Kaiser GC, Lacson AG, Gilbert-Barness E, et al. Vanishing bile duct syndrome: amoxicillin-clavulanic acid associated intra- hepatic cholestasis responsive to ursodeoxycholic acid. J Pediatr Gastroenterol Nutr 2005;41:469-73.   DOI   ScienceOn
8 Gokce S, Durmaz O, Celtik C, Aydogan A, Gulluoglu M, Sokucu S. Valproic acid-associated vanishing bile duct syndrome. J Child Neurol 2010;25:909-11.   DOI
9 Chawla A, Kahn E, Yunis EJ, Daum F. Rapidly progressive cholestasis: an unusual reaction to amoxicillin/ clavulanic acid therapy in a child. J Pediatr 2000;136:121-3.   DOI   ScienceOn
10 Stricker BH, Van den Broek JW, Keuning J, Eberhardt W, Houben HG, Johnson M, et al. Cholestatic hepatitis due to antibacterial combination of amoxicillin and clavulanic acid (augmentin) Dig Dis Sci 1989;34: 1576-80.   DOI
11 Srivastava M, Perez-Atayde A, Jonas MM. Drug-associated acute-onset vanishing bile duct and Stevens- Johnson syndromes in a child. Gastroenterology 1998;115:743-6.   DOI   ScienceOn
12 Taghian M, Tran TA, Bresson-Hadni S, Menget A, Felix S, Jacquemin E. Acute vanishing bile duct syndrome after ibuprofen therapy in a child. J Pediatr 2004; 145:273-6.   DOI   ScienceOn
13 Jang GC, Moon KR, Suh CH. A case of vanishing bile duct syndrome associated with ibuprofen overuse. Korean J Pediatr Gastroenterol Nutr 2006;9:262-8.
14 Garcia M, Mhanna MJ, Chung-Park MJ, Davis PH, Srivastava MD. Efficacy of early immunosuppressive therapy in a child with carbamazepine-associated vanishing bile duct and Stevens-Johnson syndromes. Dig Dis Sci 2002;47:177-82.   DOI   ScienceOn
15 Bhayana H, Appasani S, Thapa BR, Das A, Singh K. Lamotrigine-induced vanishing bile duct syndrome in a child. J Pediatr Gastroenterol Nutr 2012;55:e147-8.   DOI
16 Geubel AP, Sempoux CL. Drug and toxin-induced bile duct disorders. J Gastroenterol Hepatol 2000;15:1232-8.
17 Benichou C. Criteria of drug-induced liver disorders. Report of an international consensus meeting. J Hepatol 1990;11:272-6.   DOI   ScienceOn
18 Reau NS, Jensen DM. Vanishing bile duct syndrome. Clin Liver Dis 2008;12:203-17.   DOI   ScienceOn