Metronidazole-induced hepatotoxicity in a patient with xeroderma pigmentosum: A case report

Rationale:Whereas metronidazole-induced hepatotoxicity is quite rare in the general population, in individuals carrying a nucleotide excision repair disorder, namely Cockayne syndrome, there is a high risk of developing this complication.Patient concerns:We report the case of a 44-year-old man, affected by xeroderma pigmentosum, who was admitted to the hospital presenting aspiration pneumoniae caused by worsening dysphagia and with severe hepatotoxicity during the hospitalization.Diagnoses:Acute hepatitis, which was leading to acute liver failure, occurred during antibiotic treatment with metronidazole and ceftazidime with an elevation of liver enzymes consistent with hepatocellular damage pattern.Interventions:Hydration with glucose 5% solution, pantoprazole and vitamin K were administered, meanwhile other causes of hepatitis were ruled out and the ongoing antibiotic treatment was stopped suspecting a drug-induced liver injury.Outcomes:Liver function nearly completely recovered 1 month later with a first rapid improvement, within few days, of aminotransferases and coagulation studies, and slower of cholestatic enzymes.Lessons:We describe the first case available in the literature of hepatotoxicity associated with metronidazole treatment in a xeroderma pigmentosum patient. Clinicians therefore, based on this report and according to the possible underlying mechanism shared by other genetic diseases characterized by alterations in the pathway of DNA-repair, should consider such adverse event also in patients affected by this rare disease.     

Feto-maternal safety of intracervical sodium nitroprusside application in sheep

The feto-maternal safety of sodium nitroprusside (SNP) administration in the cervix of pregnant sheep is evaluated. Chronically catheterized pregnant sheep at approximately 0.9 gestation were divided into 2 groups that received 0.1 mg/kg maternal body weight of SNP gel (2%) or placebo into the internal cervical os. SNP or placebo gel was administered at 9 AM with both maternal and fetal blood gas/pH, and cardiovascular parameters were monitored for 6 hours. Except for a slight transient decrease of maternal oxygen and meta-hemoglobin content, and fetal oxygen content in the SNP group, no other significant changes were observed. However, such changes are minimal and unlikely to be of any clinical significance. Moreover, nitric oxide metabolites were unchanged in both maternal and fetal circulations.These data demonstrate few, if any, effects of intrauterine SNP administration on both cellular oxygenation and cardiovascular indexes. Thus, SNP treatment, once applied into the cervix, could be considered a safe procedure.     

Antiproliferative oleanane saponins from Meryta denhamii

Eight new oleanane saponins (1- 8) together with four know saponins (9-12) were isolated from the aerial parts of Meryta denhamii. Their structures were elucidated by 1D and 2D NMR experiments including 1D TOCSY, DQF-COSY, ROESY, HSQC, and HMBC spectroscopy, as well as ESIMS analysis. The antiproliferative activity of all compounds was evaluated using three murine and human cancer cell lines: J774.A1, HEK-293, and WEHI-164.     

Molecular analysis of the β-catenin gene in patients with the Mayer-Rokitansky-Küster-Hauser syndrome

Purpose

To study the β-catenin gene in a group of Mayer-Rokitansky-Küster-Hauser patients.

Methods

Twelve patients with the Mayer-Rokitansky-Küster-Hauser syndrome were included in this study. DNA was extracted from peripheral blood and the region codifying β-catenin GSK-3β phosphorylation sites on exon 3 was amplified. PCR products were purified and directly sequenced.

Results

No mutations were found in the GSK-3β phosphorylation sites on exon 3 of β-catenin gene in this group of patients with the MRKH syndrome.

Conclusions

β-catenin gene mutations are an unlikely cause of the MRKH syndrome.