Vanishing bile duct syndrome associated with azithromycin in a 62-year-old man.

Abstract

Vanishing bile duct syndrome is a severe cholestatic disease associated with toxic effects of medications. Stevens-Johnson syndrome is a hypersensitivity disorder that may also be caused by medications. We present a case of a 62-year-old male patient who developed vanishing bile duct syndrome a month after Stevens-Johnson syndrome. These adverse drug reactions were associated with the use of azithromycin (500 mg daily for 3 days). The patient was initially treated for Stevens-Johnson syndrome with steroids, antihistamines and proton pump inhibitors and fully recovered. However, a month after the beginning of Stevens-Johnson syndrome, he developed vanishing bile duct syndrome and was treated with steroids, ursodeoxycholic acid, antihistamines and tacrolimus. Unfortunately, the treatment was unsuccessful and he was listed for liver transplantation which was performed 7 months after the beginning of jaundice. This is the first case of vanishing bile duct syndrome associated with the use of azithromycin and one of few that reports vanishing bile duct syndrome and Stevens-Johnson syndrome co-occurrence.

• Authors: Danica Juricic, Juricic Danica, Irena Hrstic, Hrstic Irena, Davor Radic, Radic Davor, Mate Skegro, Skegro Mate, Marijana Coric, Coric Marijana, Boris Vucelic, Vucelic Boris, Igor Francetic, Francetic Igor
• Journal: Basic & clinical pharmacology & toxicology (Basic Clin Pharmacol Toxicol) Vol. 106 Issue 1 Pg. 62-5 (Jan 2010) ISSN: 1742-7843 [Electronic] England
• PMID: 19906050 (Publication Type: Case Reports, Journal Article)

Chemical References

• Anti-Bacterial Agents
• Azithromycin

Topics

• Anti-Bacterial Agents (adverse effects)
• Azithromycin (adverse effects)
• Bile Duct Diseases (chemically induced)
• Cholestasis (chemically induced)
• Humans
• Male
• Middle Aged
• Stevens-Johnson Syndrome (chemically induced)