RESUMO
We report a patient who developed cholestatic jaundice shortly after initiation of treatment with metformin hydrochloride. Ultrasound of the liver and abdominal CT were normal. An ERCP showed normal biliary anatomy. A percutaneous liver biopsy was obtained showing marked cholestasis, with portal edema, ductular proliferation, and acute inflammation. Metformin hydrochloride was discontinued, and the patient's jaundice resolved slowly over a period of several months. Given the onset of his jaundice 2 wk after the initiation of metformin, we believe that this case represents an example of metformin-associated hepatotoxicity, the first such case reported.
Assuntos
Colestase/induzido quimicamente , Metformina/efeitos adversos , Colangiopancreatografia Retrógrada Endoscópica , Colestase/diagnóstico , Humanos , Testes de Função Hepática , Masculino , Pessoa de Meia-IdadeRESUMO
We report a case of a 62-yr-old man with chronic hepatitis B virus (HBV)-related cirrhosis who developed hepatic decompensation after being started on lamivudine requiring liver transplantation. Decompensated liver disease while on lamivudine has been previously reported on two occasions, both HIV coinfected patients on a combination of nucleoside analogues. Our patient is alive and well nearly 2 yr after successful liver transplantation.
Assuntos
Lamivudina/efeitos adversos , Falência Hepática/induzido quimicamente , Fígado/efeitos dos fármacos , Inibidores da Transcriptase Reversa/efeitos adversos , Hepatite B Crônica/tratamento farmacológico , Humanos , Lamivudina/uso terapêutico , Fígado/patologia , Falência Hepática/patologia , Falência Hepática/cirurgia , Transplante de Fígado , Masculino , Pessoa de Meia-Idade , Inibidores da Transcriptase Reversa/uso terapêuticoRESUMO
Calcified enteroliths as a cause of intermittent small bowel obstruction is an uncommon clinical entity. The pathophysiological mechanism involves stasis of intestinal contents and has been associated with Meckel's diverticulum, tuberculosis, and regional enteritis. This case describes prophylactic operative intervention in a symptomatic patient with enteroliths as a result of Crohn's disease.
