Ticlopidine-induced prolonged cholestasis: a case report

We report a case of ticlopidine-induced prolonged cholestasis in a 60-year- old man with no previous hepatobiliary disease who presented with sudden ri ght upper abdominal pain, jaundice and pruritus three months after starting ticlopidine therapy. Other drugs taken by the patient were not considered probable causes, The diagnostic evaluation showed no biliary obstruction an d other possible causes of intra-hepatic cholestasis were excluded, The liv er biopsy showed a cholestatic hepatitis with bile duct damage. The disease ran a severe and protracted course, but symptoms and jaundice eventually s ubsided five months after drug withdrawal, More than a year later, relevant abnormalities of liver function tests consistent with anicteric cholestasi s still persist, fulfilling criteria for a minor form of drug-induced prolo nged cholestasis. This syndrome has been reported infrequently in relation to several drugs, mainly chlorpromazine, and only once with ticlopidine. Eu r J Gastroenterol Hepatol 11:673-676. (C) 1999 Lippincott Williams & Wilkin s.