1 / 10

Drug Induced Hepatitis

Drug Induced Hepatitis. Clinical Presentation. 68 year old woman Jaundice Mild epigastric pain Fatigue Pruritus Dark urine/light stools Diarrhea X 4 1/2 months 6 months prior. 7 days. Diarrhea. LFTs  nl stools  C&S, O&P, Giardia. 2 months.

libitha
Télécharger la présentation

Drug Induced Hepatitis

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Drug Induced Hepatitis

  2. Clinical Presentation 68 year old woman Jaundice Mild epigastric pain Fatigue Pruritus Dark urine/light stools Diarrhea X 41/2months 6 monthsprior 7 days

  3. Diarrhea LFTs  nl stools  C&S, O&P, Giardia 2 months Flagyl X 2 weeks 2 months Colonoscopy bx  mild colitis mesalamine (2.4 g/d) 2 months Jaundice

  4. Medications Metoprolol, perindopril, diovan Synthroid Mesalamine Social History No alcohol No recent travel Family history Non contributory

  5. Physical Exam BMI = 32 Marked scleral icterus Mild abdominal tenderness RUQ No hepatomegaly/splenomegaly No ascites, spider angiomata, palmar erythema, asterixis

  6. Laboratory/Imaging Labs AST 1105, ALT 1005 AlkP 312 Tbil 16.7 Dbil 10 INR 1.3, Alb=3.0 Imaging Ultrasound  mildly echogenic liver Serology Acute viral hepatitis A, B serology  NL Autoimmune serology  NL

  7. AST 1105 ALT 1005 AP 312 Tbil 16.7 All meds stopped 2 weeks AST 987 ALT 818 AP 324 Tbil> 30 AST 487; ALT 410 AP 292 Tbil> 30 2 weeks Laparoscopy Ursodeoxycholic acid AST 483 ALT 282 AP 254 Tbil 14 3 weeks AST 38 ALT 43 AP 176 Tbil 1.4 6 weeks AST 25; ALT 24 AP 90 Tbil 0.9

  8. Laparoscopy

  9. AST 1105 ALT 1005 Tbil 16.7 All meds stopped 2 weeks AST 987 ALT 818 Tbil> 30 AST 487; ALT 410 Tbil> 30 2 weeks Laparoscopy Ursodeoxycholic acid AST 483 ALT 282 Tbil 14 3 weeks AST 38 ALT 43 Tbil 1.4 6 weeks AST 25; ALT 24 Tbil 0.9

More Related