Urosodeoxycholic Acid Therapy in a Child with Trimethoprim- Sulfamethoxazole-induced Vanishing Bile Duct Syndrome
조현정, 좌혜정, Kim Kyu-Seon, 강대용, 김재영,
소속 상세정보
조현정 ( Cho Hyun-Jeong )
Chungnam National University School of Medicine Department of Pediatrics
좌혜정 ( Jwa Hye-Jeong )
Chungnam National University School of Medicine Department of Pediatrics
( Kim Kyu-Seon )
Chungnam National University School of Medicine Department of Pediatrics
강대용 ( Gang Dae-Yong )
Chungnam National University School of Medicine Department of Pathology
김재영 ( Kim Jae-Young )
Chungnam National University School of Medicine Department of Pediatrics
KMID : 0816120130160040273
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 trimetho-prime-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 gam-ma-glutamyl transpeptidase after or during taking medicine to treat nonhepatobiliary diseases illness.
키워드
Cholestasis; Trimethoprim-sulfamethoxazole combination
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