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Case Reports
. 2020 Aug 13;12(8):e9713.
doi: 10.7759/cureus.9713.

Delayed Presentation of Drug-Induced Hepatic Injury

Shohana Ahmed  1 , Nirmal K Onteddu  2 , Ali Jabur  1 , Sai Swarupa R Vulasala  3 , Swapna Kolli  4
Affiliations
Case Reports

Delayed Presentation of Drug-Induced Hepatic Injury

Shohana Ahmed et al. Cureus. .

Abstract

Drug-induced hepatotoxicity is a major cause of acute liver failure (ALF) in the United States. There are many offending agents like prescription drugs and herbal remedies. However, the most common prescription medication involved worldwide is amoxicillin-clavulanate. We report an unusually delayed presentation of severe cholestatic hepatitis caused by amoxicillin-clavulanate in a 20-year-old female with worsening hyperbilirubinemia that was successfully treated with corticosteroids and ursodeoxycholic acid (UDCA).

Keywords: amoxicillin – clavulanate; drug-induced liver disease; udca therapy.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. CT abdomen and pelvis showing contracted gall bladder.
Figure 2
Figure 2. MRCP showing patent common bile duct (black arrow) and pancreatic duct (red arrow).
MRCP, magnetic resonance cholangiopancreatography
Figure 3
Figure 3. Inflammation of Zone 1 and Zone 3.
Figure 4
Figure 4. Acute lobular inflammation.
Figure 5
Figure 5. Mixed portal inflammation with eosinophils.
Figure 6
Figure 6. Portal mixed inflammation with eosinophils.
Figure 7
Figure 7. H&E cholestasis.
H&E, hemotoxylin and eosin
See this image and copyright information in PMC

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