ANTIBIOTIC-ASSOCIATED ACUTE VANISHING BILE-DUCT SYNDROME - A PATTERN ASSOCIATED WITH SEVERE, PROLONGED, INTRAHEPATIC CHOLESTASIS

We report cases of amoxycillin- and flucloxacillin-induced liver damag e associated with an acute vanishing bile duct syndrome. Ductopenia wa s present at the time of first liver biopsy, 3 weeks and 3 months afte r administration of the two drugs, respectively. Ductopenia apparently occurred as the primary lesion, with no evidence of accompanying port al tract inflammation. Subsequent biopsies showed a persistent paucity of ducts, accompanied by increasing features of chronic cholestasis. Biochemical dysfunction persists at 2 year's follow-up and late progno sis remains guarded. (C) Journal of Hepatology.