A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis
This Case Study describes a 47-year-old woman who was treated with indomethacin for osteoarthritis-related hip pain. Soon after beginning treatment she developed nausea, vomiting, abdominal pain, dark urine and jaundice. Despite discontinuing all medications, her symptoms worsened. Treatment with pr...
Gespeichert in:
| Veröffentlicht in: | Nature clinical practice. Gastroenterology & hepatology 2008-03, Vol.5 (3), p.172-176 |
|---|---|
| Hauptverfasser: | , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 176 |
|---|---|
| container_issue | 3 |
| container_start_page | 172 |
| container_title | Nature clinical practice. Gastroenterology & hepatology |
| container_volume | 5 |
| creator | Abraham, Clara Hart, John Locke, Susan M Baker, Alfred L |
| description | This Case Study describes a 47-year-old woman who was treated with indomethacin for osteoarthritis-related hip pain. Soon after beginning treatment she developed nausea, vomiting, abdominal pain, dark urine and jaundice. Despite discontinuing all medications, her symptoms worsened. Treatment with prednisone 40 mg/day was initially successful, but after tapering (over 18 months) and then discontinuing prednisone her liver chemistry test results worsened and a liver biopsy showed evidence of chronic hepatitis.
Background
A 47-year-old woman who presented with hip pain as a result of osteoarthritis was treated with indometacin. Ten days after beginning treatment she developed jaundice and ascites. All medications were discontinued, but her symptoms continued to worsen.
Investigations
Physical examination, laboratory tests and radiologic examinations, including liver chemistry tests, viral serologies, serum iron studies, ceruloplasmin and alpha-fetoprotein analyses, autoimmune serologies, ascites studies, abdominal CT, liver ultrasound and liver biopsy.
Diagnosis
Severe biopsy-proven hepatitis that progressed to chronic autoimmune hepatitis.
Management
Treatment with prednisone 40 mg/day was initially successful. The dose of the therapy was tapered over 18 months and then discontinued, after which time the patient's liver chemistry test results worsened. Repeat liver biopsy samples showed evidence of chronic hepatitis, and her liver chemistry test results improved when prednisone was restarted. The patient was maintained on 750 mg twice-daily mycophenolate mofetil and prednisone was decreased to 5 mg every other day. |
| doi_str_mv | 10.1038/ncpgasthep1055 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_proqu</sourceid><recordid>TN_cdi_proquest_journals_1788524867</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A184854319</galeid><sourcerecordid>A184854319</sourcerecordid><originalsourceid>FETCH-LOGICAL-c457t-50441fe38e72f496fd419fa860ea833f875d85819ae40a69f342541b20b308963</originalsourceid><addsrcrecordid>eNp1kctrJCEQxiVkyWtzzTE0JNdOtNW2-jiEvCCwl93LXhrHLieGae2oHdj_fg0z5LFk8WBh_b6vLD5CThi9YJTDpTfTSqf8iBOjUu6QA6YErwWHdvetVrBPDlN6opQrxbs9ss-gaRQwOCC_F5XRCatgK-eHMGLWxvm61LPBodJmzlgVd51ddqka8AXXYXJ-VfAcKvMYg3em0nMObhxn_wH-Tr5ZvU54vL2PyK-b659Xd_XDj9v7q8VDbYRUuZZUCGaRA6rGiq61g2Cd1dBS1MC5BSUHkMA6jYLqtrNcNFKwZUOXnELX8iNytvGdYnieMeX-KczRl5E9UwCyEdCqd2ql19g7b0OO2owumX7BQIAUnHWFuviCKmfA0Zng0bry_pXAxJBSRNtP0Y06_ukZ7V8T6j8nVASn29_OyxGHd3wbSQEuN0AqLb_C-GGd_1mebxRe5znim-U_2F9NN6rK</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1788524867</pqid></control><display><type>article</type><title>A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis</title><source>MEDLINE</source><source>Nature Journals Online</source><source>SpringerLink Journals - AutoHoldings</source><creator>Abraham, Clara ; Hart, John ; Locke, Susan M ; Baker, Alfred L</creator><creatorcontrib>Abraham, Clara ; Hart, John ; Locke, Susan M ; Baker, Alfred L</creatorcontrib><description>This Case Study describes a 47-year-old woman who was treated with indomethacin for osteoarthritis-related hip pain. Soon after beginning treatment she developed nausea, vomiting, abdominal pain, dark urine and jaundice. Despite discontinuing all medications, her symptoms worsened. Treatment with prednisone 40 mg/day was initially successful, but after tapering (over 18 months) and then discontinuing prednisone her liver chemistry test results worsened and a liver biopsy showed evidence of chronic hepatitis.
Background
A 47-year-old woman who presented with hip pain as a result of osteoarthritis was treated with indometacin. Ten days after beginning treatment she developed jaundice and ascites. All medications were discontinued, but her symptoms continued to worsen.
Investigations
Physical examination, laboratory tests and radiologic examinations, including liver chemistry tests, viral serologies, serum iron studies, ceruloplasmin and alpha-fetoprotein analyses, autoimmune serologies, ascites studies, abdominal CT, liver ultrasound and liver biopsy.
Diagnosis
Severe biopsy-proven hepatitis that progressed to chronic autoimmune hepatitis.
Management
Treatment with prednisone 40 mg/day was initially successful. The dose of the therapy was tapered over 18 months and then discontinued, after which time the patient's liver chemistry test results worsened. Repeat liver biopsy samples showed evidence of chronic hepatitis, and her liver chemistry test results improved when prednisone was restarted. The patient was maintained on 750 mg twice-daily mycophenolate mofetil and prednisone was decreased to 5 mg every other day.</description><identifier>ISSN: 1743-4378</identifier><identifier>ISSN: 1759-5045</identifier><identifier>EISSN: 1743-4386</identifier><identifier>EISSN: 1759-5053</identifier><identifier>DOI: 10.1038/ncpgasthep1055</identifier><identifier>PMID: 18227818</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>Acute Disease ; Anti-Inflammatory Agents, Non-Steroidal - adverse effects ; Biomedicine ; Care and treatment ; Case studies ; case-study ; Chemical and Drug Induced Liver Injury, Chronic - drug therapy ; Chemical and Drug Induced Liver Injury, Chronic - etiology ; Chemical and Drug Induced Liver Injury, Chronic - pathology ; Chronic active hepatitis ; Complications and side effects ; Diagnosis ; Disease Progression ; Dosage and administration ; Female ; Gastroenterology ; Hepatitis, Autoimmune - drug therapy ; Hepatitis, Autoimmune - etiology ; Hepatitis, Autoimmune - pathology ; Hepatology ; Humans ; Indomethacin ; Indomethacin - adverse effects ; Medicine ; Medicine & Public Health ; Middle Aged ; Osteoarthritis, Hip - drug therapy ; Risk factors</subject><ispartof>Nature clinical practice. Gastroenterology & hepatology, 2008-03, Vol.5 (3), p.172-176</ispartof><rights>Springer Nature Limited 2008</rights><rights>COPYRIGHT 2008 Nature Publishing Group</rights><rights>Copyright Nature Publishing Group Mar 2008</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c457t-50441fe38e72f496fd419fa860ea833f875d85819ae40a69f342541b20b308963</citedby><cites>FETCH-LOGICAL-c457t-50441fe38e72f496fd419fa860ea833f875d85819ae40a69f342541b20b308963</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,2726,27923,27924</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18227818$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abraham, Clara</creatorcontrib><creatorcontrib>Hart, John</creatorcontrib><creatorcontrib>Locke, Susan M</creatorcontrib><creatorcontrib>Baker, Alfred L</creatorcontrib><title>A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis</title><title>Nature clinical practice. Gastroenterology & hepatology</title><addtitle>Nat Rev Gastroenterol Hepatol</addtitle><addtitle>Nat Clin Pract Gastroenterol Hepatol</addtitle><description>This Case Study describes a 47-year-old woman who was treated with indomethacin for osteoarthritis-related hip pain. Soon after beginning treatment she developed nausea, vomiting, abdominal pain, dark urine and jaundice. Despite discontinuing all medications, her symptoms worsened. Treatment with prednisone 40 mg/day was initially successful, but after tapering (over 18 months) and then discontinuing prednisone her liver chemistry test results worsened and a liver biopsy showed evidence of chronic hepatitis.
Background
A 47-year-old woman who presented with hip pain as a result of osteoarthritis was treated with indometacin. Ten days after beginning treatment she developed jaundice and ascites. All medications were discontinued, but her symptoms continued to worsen.
Investigations
Physical examination, laboratory tests and radiologic examinations, including liver chemistry tests, viral serologies, serum iron studies, ceruloplasmin and alpha-fetoprotein analyses, autoimmune serologies, ascites studies, abdominal CT, liver ultrasound and liver biopsy.
Diagnosis
Severe biopsy-proven hepatitis that progressed to chronic autoimmune hepatitis.
Management
Treatment with prednisone 40 mg/day was initially successful. The dose of the therapy was tapered over 18 months and then discontinued, after which time the patient's liver chemistry test results worsened. Repeat liver biopsy samples showed evidence of chronic hepatitis, and her liver chemistry test results improved when prednisone was restarted. The patient was maintained on 750 mg twice-daily mycophenolate mofetil and prednisone was decreased to 5 mg every other day.</description><subject>Acute Disease</subject><subject>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</subject><subject>Biomedicine</subject><subject>Care and treatment</subject><subject>Case studies</subject><subject>case-study</subject><subject>Chemical and Drug Induced Liver Injury, Chronic - drug therapy</subject><subject>Chemical and Drug Induced Liver Injury, Chronic - etiology</subject><subject>Chemical and Drug Induced Liver Injury, Chronic - pathology</subject><subject>Chronic active hepatitis</subject><subject>Complications and side effects</subject><subject>Diagnosis</subject><subject>Disease Progression</subject><subject>Dosage and administration</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatitis, Autoimmune - drug therapy</subject><subject>Hepatitis, Autoimmune - etiology</subject><subject>Hepatitis, Autoimmune - pathology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Indomethacin</subject><subject>Indomethacin - adverse effects</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Osteoarthritis, Hip - drug therapy</subject><subject>Risk factors</subject><issn>1743-4378</issn><issn>1759-5045</issn><issn>1743-4386</issn><issn>1759-5053</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kctrJCEQxiVkyWtzzTE0JNdOtNW2-jiEvCCwl93LXhrHLieGae2oHdj_fg0z5LFk8WBh_b6vLD5CThi9YJTDpTfTSqf8iBOjUu6QA6YErwWHdvetVrBPDlN6opQrxbs9ss-gaRQwOCC_F5XRCatgK-eHMGLWxvm61LPBodJmzlgVd51ddqka8AXXYXJ-VfAcKvMYg3em0nMObhxn_wH-Tr5ZvU54vL2PyK-b659Xd_XDj9v7q8VDbYRUuZZUCGaRA6rGiq61g2Cd1dBS1MC5BSUHkMA6jYLqtrNcNFKwZUOXnELX8iNytvGdYnieMeX-KczRl5E9UwCyEdCqd2ql19g7b0OO2owumX7BQIAUnHWFuviCKmfA0Zng0bry_pXAxJBSRNtP0Y06_ukZ7V8T6j8nVASn29_OyxGHd3wbSQEuN0AqLb_C-GGd_1mebxRe5znim-U_2F9NN6rK</recordid><startdate>20080301</startdate><enddate>20080301</enddate><creator>Abraham, Clara</creator><creator>Hart, John</creator><creator>Locke, Susan M</creator><creator>Baker, Alfred L</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope></search><sort><creationdate>20080301</creationdate><title>A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis</title><author>Abraham, Clara ; Hart, John ; Locke, Susan M ; Baker, Alfred L</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c457t-50441fe38e72f496fd419fa860ea833f875d85819ae40a69f342541b20b308963</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acute Disease</topic><topic>Anti-Inflammatory Agents, Non-Steroidal - adverse effects</topic><topic>Biomedicine</topic><topic>Care and treatment</topic><topic>Case studies</topic><topic>case-study</topic><topic>Chemical and Drug Induced Liver Injury, Chronic - drug therapy</topic><topic>Chemical and Drug Induced Liver Injury, Chronic - etiology</topic><topic>Chemical and Drug Induced Liver Injury, Chronic - pathology</topic><topic>Chronic active hepatitis</topic><topic>Complications and side effects</topic><topic>Diagnosis</topic><topic>Disease Progression</topic><topic>Dosage and administration</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatitis, Autoimmune - drug therapy</topic><topic>Hepatitis, Autoimmune - etiology</topic><topic>Hepatitis, Autoimmune - pathology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Indomethacin</topic><topic>Indomethacin - adverse effects</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Osteoarthritis, Hip - drug therapy</topic><topic>Risk factors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abraham, Clara</creatorcontrib><creatorcontrib>Hart, John</creatorcontrib><creatorcontrib>Locke, Susan M</creatorcontrib><creatorcontrib>Baker, Alfred L</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><jtitle>Nature clinical practice. Gastroenterology & hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abraham, Clara</au><au>Hart, John</au><au>Locke, Susan M</au><au>Baker, Alfred L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis</atitle><jtitle>Nature clinical practice. Gastroenterology & hepatology</jtitle><stitle>Nat Rev Gastroenterol Hepatol</stitle><addtitle>Nat Clin Pract Gastroenterol Hepatol</addtitle><date>2008-03-01</date><risdate>2008</risdate><volume>5</volume><issue>3</issue><spage>172</spage><epage>176</epage><pages>172-176</pages><issn>1743-4378</issn><issn>1759-5045</issn><eissn>1743-4386</eissn><eissn>1759-5053</eissn><abstract>This Case Study describes a 47-year-old woman who was treated with indomethacin for osteoarthritis-related hip pain. Soon after beginning treatment she developed nausea, vomiting, abdominal pain, dark urine and jaundice. Despite discontinuing all medications, her symptoms worsened. Treatment with prednisone 40 mg/day was initially successful, but after tapering (over 18 months) and then discontinuing prednisone her liver chemistry test results worsened and a liver biopsy showed evidence of chronic hepatitis.
Background
A 47-year-old woman who presented with hip pain as a result of osteoarthritis was treated with indometacin. Ten days after beginning treatment she developed jaundice and ascites. All medications were discontinued, but her symptoms continued to worsen.
Investigations
Physical examination, laboratory tests and radiologic examinations, including liver chemistry tests, viral serologies, serum iron studies, ceruloplasmin and alpha-fetoprotein analyses, autoimmune serologies, ascites studies, abdominal CT, liver ultrasound and liver biopsy.
Diagnosis
Severe biopsy-proven hepatitis that progressed to chronic autoimmune hepatitis.
Management
Treatment with prednisone 40 mg/day was initially successful. The dose of the therapy was tapered over 18 months and then discontinued, after which time the patient's liver chemistry test results worsened. Repeat liver biopsy samples showed evidence of chronic hepatitis, and her liver chemistry test results improved when prednisone was restarted. The patient was maintained on 750 mg twice-daily mycophenolate mofetil and prednisone was decreased to 5 mg every other day.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>18227818</pmid><doi>10.1038/ncpgasthep1055</doi><tpages>5</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1743-4378 |
| ispartof | Nature clinical practice. Gastroenterology & hepatology, 2008-03, Vol.5 (3), p.172-176 |
| issn | 1743-4378 1759-5045 1743-4386 1759-5053 |
| language | eng |
| recordid | cdi_proquest_journals_1788524867 |
| source | MEDLINE; Nature Journals Online; SpringerLink Journals - AutoHoldings |
| subjects | Acute Disease Anti-Inflammatory Agents, Non-Steroidal - adverse effects Biomedicine Care and treatment Case studies case-study Chemical and Drug Induced Liver Injury, Chronic - drug therapy Chemical and Drug Induced Liver Injury, Chronic - etiology Chemical and Drug Induced Liver Injury, Chronic - pathology Chronic active hepatitis Complications and side effects Diagnosis Disease Progression Dosage and administration Female Gastroenterology Hepatitis, Autoimmune - drug therapy Hepatitis, Autoimmune - etiology Hepatitis, Autoimmune - pathology Hepatology Humans Indomethacin Indomethacin - adverse effects Medicine Medicine & Public Health Middle Aged Osteoarthritis, Hip - drug therapy Risk factors |
| title | A case of indometacin-induced acute hepatitis developing into chronic autoimmune hepatitis |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T09%3A52%3A43IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_proqu&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=A%20case%20of%20indometacin-induced%20acute%20hepatitis%20developing%20into%20chronic%20autoimmune%20hepatitis&rft.jtitle=Nature%20clinical%20practice.%20Gastroenterology%20&%20hepatology&rft.au=Abraham,%20Clara&rft.date=2008-03-01&rft.volume=5&rft.issue=3&rft.spage=172&rft.epage=176&rft.pages=172-176&rft.issn=1743-4378&rft.eissn=1743-4386&rft_id=info:doi/10.1038/ncpgasthep1055&rft_dat=%3Cgale_proqu%3EA184854319%3C/gale_proqu%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1788524867&rft_id=info:pmid/18227818&rft_galeid=A184854319&rfr_iscdi=true |