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. 2009:2009:bcr09.2008.0950.
doi: 10.1136/bcr.09.2008.0950. Epub 2009 Jul 14.

Metformin-induced cholangiohepatitis

Raja Shekhar Reddy Sappati Biyyani  1 , Smitha Battula, Christopher A Erhardt, Khalil Korkor
Affiliations

Metformin-induced cholangiohepatitis

Raja Shekhar Reddy Sappati Biyyani et al. BMJ Case Rep. 2009.

Abstract

Drug-induced cholangiohepatitis accounts for 20-50% of non-viral chronic hepatitis cases. Metformin is the most commonly prescribed oral anti-diabetic drug from the biguanide class used in treatment of overweight and obese type 2 diabetes mellitus patients. Metformin-induced cholangiohepatitis with marked elevations in serum liver transaminases and intrahepatic cholestasis has been infrequently reported. Here, we report a case of acute cholangiohepatitis after initiation of metformin treatment.

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Figures

Figure 1
Figure 1
Portal triaditis with abundant eosinophils (400×).
Figure 2
Figure 2
Portal triaditis with intraepithelial neutrophils (400×).
Figure 3
Figure 3
Bile ductular proliferation (200×).
Figure 4
Figure 4
Portal triaditis with spill-over across the limiting plate (200×).
See this image and copyright information in PMC

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