Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency

Ayse L. Mindikoglu, Abhinandana Anantharaju, Grace G. Hartman, Shilun Li, Jaime Villanueva, David H. Van Thiel

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

A case of a 58-year-old woman with history of bilateral lung transplant secondary to alpha-1 antitrypsin deficiency (PIZZ), who presented with a severe drug-induced cholestasis secondary to prochlorperazine is reported. After 27 months of prochlorperazine use, she developed liver failure consisting of jaundice with ascites. Computed tomography of the abdomen, abdominal ultrasonography as well as an endoscopic retrograde cholangiopancreatography showed no evidence for biliary obstruction. Liver biopsy demonstrated diffuse ongoing advanced chronic cholestasis, moderate portal and periportal inflammation as well as bridging fibrosis. During her hospitalization, her total bilirubin increased to 38.6mg/dL; alkaline phosphatase to 362 IU/L, alanine aminotransferase to 71 IU/L and aspartate aminotransferase to 88 IU/L. After several weeks of ursodiol therapy without clinical improvement the prochlorperazine was discontinued and was followed by a rapid improvement in her measures of liver injury. An immediate decline of her serum total bilirubin and alkaline phosphatase to 21.4mg/dL and 258 IU/L, respectively, occurred strongly suggesting the idea of a prochlorperazine-induced injury.

Original languageEnglish (US)
Pages (from-to)1338-1340
Number of pages3
JournalHepato-Gastroenterology
Volume50
Issue number53
StatePublished - Sep 1 2003
Externally publishedYes

Fingerprint

Prochlorperazine
alpha 1-Antitrypsin Deficiency
Cholestasis
Bilirubin
Alkaline Phosphatase
Ursodeoxycholic Acid
Endoscopic Retrograde Cholangiopancreatography
Liver
Liver Failure
Wounds and Injuries
Aspartate Aminotransferases
Jaundice
Alanine Transaminase
Ascites
Aspartic Acid
Alanine
Abdomen
Ultrasonography
Hospitalization
Fibrosis

Keywords

  • Alpha-1 antitrypsin deficiency
  • Cholestasis
  • Cirrhosis
  • Phenothiazine
  • Prochlorperazine

ASJC Scopus subject areas

  • Medicine(all)
  • Hepatology
  • Gastroenterology

Cite this

Mindikoglu, A. L., Anantharaju, A., Hartman, G. G., Li, S., Villanueva, J., & Van Thiel, D. H. (2003). Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency. Hepato-Gastroenterology, 50(53), 1338-1340.

Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency. / Mindikoglu, Ayse L.; Anantharaju, Abhinandana; Hartman, Grace G.; Li, Shilun; Villanueva, Jaime; Van Thiel, David H.

In: Hepato-Gastroenterology, Vol. 50, No. 53, 01.09.2003, p. 1338-1340.

Research output: Contribution to journalArticle

Mindikoglu, AL, Anantharaju, A, Hartman, GG, Li, S, Villanueva, J & Van Thiel, DH 2003, 'Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency', Hepato-Gastroenterology, vol. 50, no. 53, pp. 1338-1340.
Mindikoglu AL, Anantharaju A, Hartman GG, Li S, Villanueva J, Van Thiel DH. Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency. Hepato-Gastroenterology. 2003 Sep 1;50(53):1338-1340.
Mindikoglu, Ayse L. ; Anantharaju, Abhinandana ; Hartman, Grace G. ; Li, Shilun ; Villanueva, Jaime ; Van Thiel, David H. / Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency. In: Hepato-Gastroenterology. 2003 ; Vol. 50, No. 53. pp. 1338-1340.
@article{d3861758d9ae4a07aeee21d298fc6b3c,
title = "Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency",
abstract = "A case of a 58-year-old woman with history of bilateral lung transplant secondary to alpha-1 antitrypsin deficiency (PIZZ), who presented with a severe drug-induced cholestasis secondary to prochlorperazine is reported. After 27 months of prochlorperazine use, she developed liver failure consisting of jaundice with ascites. Computed tomography of the abdomen, abdominal ultrasonography as well as an endoscopic retrograde cholangiopancreatography showed no evidence for biliary obstruction. Liver biopsy demonstrated diffuse ongoing advanced chronic cholestasis, moderate portal and periportal inflammation as well as bridging fibrosis. During her hospitalization, her total bilirubin increased to 38.6mg/dL; alkaline phosphatase to 362 IU/L, alanine aminotransferase to 71 IU/L and aspartate aminotransferase to 88 IU/L. After several weeks of ursodiol therapy without clinical improvement the prochlorperazine was discontinued and was followed by a rapid improvement in her measures of liver injury. An immediate decline of her serum total bilirubin and alkaline phosphatase to 21.4mg/dL and 258 IU/L, respectively, occurred strongly suggesting the idea of a prochlorperazine-induced injury.",
keywords = "Alpha-1 antitrypsin deficiency, Cholestasis, Cirrhosis, Phenothiazine, Prochlorperazine",
author = "Mindikoglu, {Ayse L.} and Abhinandana Anantharaju and Hartman, {Grace G.} and Shilun Li and Jaime Villanueva and {Van Thiel}, {David H.}",
year = "2003",
month = "9",
day = "1",
language = "English (US)",
volume = "50",
pages = "1338--1340",
journal = "Acta hepato-splenologica",
issn = "0172-6390",
publisher = "H.G.E. Update Medical Publishing Ltd.",
number = "53",

}

TY - JOUR

T1 - Prochlorperazine-induced cholestasis in a patient with alpha-1 antitrypsin deficiency

AU - Mindikoglu, Ayse L.

AU - Anantharaju, Abhinandana

AU - Hartman, Grace G.

AU - Li, Shilun

AU - Villanueva, Jaime

AU - Van Thiel, David H.

PY - 2003/9/1

Y1 - 2003/9/1

N2 - A case of a 58-year-old woman with history of bilateral lung transplant secondary to alpha-1 antitrypsin deficiency (PIZZ), who presented with a severe drug-induced cholestasis secondary to prochlorperazine is reported. After 27 months of prochlorperazine use, she developed liver failure consisting of jaundice with ascites. Computed tomography of the abdomen, abdominal ultrasonography as well as an endoscopic retrograde cholangiopancreatography showed no evidence for biliary obstruction. Liver biopsy demonstrated diffuse ongoing advanced chronic cholestasis, moderate portal and periportal inflammation as well as bridging fibrosis. During her hospitalization, her total bilirubin increased to 38.6mg/dL; alkaline phosphatase to 362 IU/L, alanine aminotransferase to 71 IU/L and aspartate aminotransferase to 88 IU/L. After several weeks of ursodiol therapy without clinical improvement the prochlorperazine was discontinued and was followed by a rapid improvement in her measures of liver injury. An immediate decline of her serum total bilirubin and alkaline phosphatase to 21.4mg/dL and 258 IU/L, respectively, occurred strongly suggesting the idea of a prochlorperazine-induced injury.

AB - A case of a 58-year-old woman with history of bilateral lung transplant secondary to alpha-1 antitrypsin deficiency (PIZZ), who presented with a severe drug-induced cholestasis secondary to prochlorperazine is reported. After 27 months of prochlorperazine use, she developed liver failure consisting of jaundice with ascites. Computed tomography of the abdomen, abdominal ultrasonography as well as an endoscopic retrograde cholangiopancreatography showed no evidence for biliary obstruction. Liver biopsy demonstrated diffuse ongoing advanced chronic cholestasis, moderate portal and periportal inflammation as well as bridging fibrosis. During her hospitalization, her total bilirubin increased to 38.6mg/dL; alkaline phosphatase to 362 IU/L, alanine aminotransferase to 71 IU/L and aspartate aminotransferase to 88 IU/L. After several weeks of ursodiol therapy without clinical improvement the prochlorperazine was discontinued and was followed by a rapid improvement in her measures of liver injury. An immediate decline of her serum total bilirubin and alkaline phosphatase to 21.4mg/dL and 258 IU/L, respectively, occurred strongly suggesting the idea of a prochlorperazine-induced injury.

KW - Alpha-1 antitrypsin deficiency

KW - Cholestasis

KW - Cirrhosis

KW - Phenothiazine

KW - Prochlorperazine

UR - http://www.scopus.com/inward/record.url?scp=0141540484&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0141540484&partnerID=8YFLogxK

M3 - Article

C2 - 14571732

AN - SCOPUS:0141540484

VL - 50

SP - 1338

EP - 1340

JO - Acta hepato-splenologica

JF - Acta hepato-splenologica

SN - 0172-6390

IS - 53

ER -