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Review
. 2017 Sep 11;1(8):726-735.
doi: 10.1002/hep4.1088. eCollection 2017 Oct.

Drug-induced cholestasis

Vinay Sundaram  1 , Einar S Björnsson  2   3
Affiliations
Review

Drug-induced cholestasis

Vinay Sundaram et al. Hepatol Commun. .

Abstract

Cholestatic drug-induced liver injury (DILI) can be a diagnostic challenge due to a large differential diagnosis, variability in clinical presentation, and lack of serologic biomarkers associated with this condition. The clinical presentation of drug-induced cholestasis includes bland cholestasis, cholestatic hepatitis, secondary sclerosing cholangitis, and vanishing bile duct syndrome. The associate mortality of cholestatic DILI can be as high as 10%, and thus prompt recognition and removal of the offending agent is of critical importance. Several risk factors have been identified for drug-induced cholestasis, including older age, genetic determinants, and properties of certain medications. Antibiotics, particularly amoxicillin/clavulanate, remain the predominant cause of cholestatic DILI, although a variety of other medications associated with this condition have been identified. In this review, we summarize the presentation, clinical approach, risk factors, implicated medications, and management of drug-induced cholestatic liver injury. (Hepatology Communications 2017;1:726-735).

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Figures

Figure 1
Figure 1
Central vein with lymphocytic infiltration and hepatocellular cholestasis, consistent with cholestatic hepatitis.
See this image and copyright information in PMC

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