Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2023 Aug 7;85(9):4629-4632.
doi: 10.1097/MS9.0000000000001135. eCollection 2023 Sep.

Clarithromycin-induced acute liver injury in a patient with positive Helicobacter pylori: a case report and review of the literature

Nava Raj Sharma  1 , Abhishesh Wagle  2 , Manoj Bist  3 , Bishal Panthi  1 , Ritu Pokhrel Dahal  4 , Rajesh Rokaya  5 , Rayana Shrestha  2 , Madalasa Pokhrel  6
Affiliations
Case Reports

Clarithromycin-induced acute liver injury in a patient with positive Helicobacter pylori: a case report and review of the literature

Nava Raj Sharma et al. Ann Med Surg (Lond). .

Abstract

Introduction and importance: While 14-day triple therapy with clarithromycin is a common approach for eradicating Helicobacter pylori infection, it is essential to note that this treatment does not come without potential side effects.

Case presentation: We present the case of a 34-year-old male who presented to the emergency department with severe vomiting and abdominal pain. Subsequent evaluation revealed that the patient had developed drug-induced liver injury (DILI).

Clinical discussion: DILI can cause acute hepatocellular or cholestatic damage, and chronic injury can lead to hepatocellular, cholestatic, vascular, or neoplastic manifestations.

Conclusion: Clinicians should exercise caution and be alert to the potential hepatotoxic effects of medications, especially when initiating triple therapy for H. pylori infection.

Keywords: Helicobacter pylori; clarithromycin; drug-induced liver injury.

PubMed Disclaimer

Conflict of interest statement

The authors declare that they have no conflicts of interest.Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Figures

Figure 1
Figure 1
Ultrasound during admission showing dilated common bile duct measuring 8.5 mm.
Figure 2
Figure 2
Ultrasound after 1 week of admission showing common bile duct measuring 5 mm.
Figure 3
Figure 3
Trend in liver function test.
See this image and copyright information in PMC

References

    1. Saleem N, Howden CW. Update on the management of Helicobacter pylori infection. Curr Treat Options Gastroenterol 2020;18:476–487. - PMC - PubMed
    1. Papastergiou V. Treatment of Helicobacter pylori infection: meeting the challenge of antimicrobial resistance. World J Gastroenterol 2014;20:9898. - PMC - PubMed
    1. Graham DY, Lee Y, Wu M. Rational Helicobacter pylori therapy: evidence-based medicine rather than medicine-based evidence. Clin Gastroenterol Hepatol 2014;12:177–186.e3. - PMC - PubMed
    1. Woodhead JL, Yang K, Oldach D, et al. Analyzing the mechanisms behind macrolide antibiotic-induced liver injury using quantitative systems toxicology modeling. Pharm Res 2019;36:48. - PMC - PubMed
    1. Edhi AI, Hakim S, Shams C, et al. Clarithromycin-associated acute liver failure leading to fatal, massive upper gastrointestinal hemorrhage from profound coagulopathy: case report and systematic literature review. Case Reports Hepatol 2020;2020:1–7. - PMC - PubMed

Publication types

LinkOut - more resources