Fosinopril-induced prolonged cholestatic jaundice and pruritus: first case report |
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Authors: | Nunes A C Amaro P Maç as F Cipriano A Martins I Rosa A Pimenta I Donato A Freitas D |
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Institution: | Department of Gastroenterology, Coimbra University Hospital, Portugal. ascrnunes@hotmail.com |
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Abstract: | We report a case of fosinopril-induced prolonged cholestatic jaundice and pruritus in a 61-year-old man, with no previous hepatobiliary disease, who presented with asthenia, jaundice and itching 3 weeks after starting fosinopril therapy. Other drugs taken by the patient were not considered probable causes. The diagnostic evaluation showed no biliary obstruction and other possible causes of intra-hepatic cholestasis were excluded. Liver biopsy showed cholestasis without bile duct damage. The disease ran a severe course during the 2 months of hospitalization, with prolonged itching for 6 months, eventually controlled with oral naltrexone. Jaundice subsided after 4 months, with anicteric cholestasis persisting for more than 18 months. Similar occurrences have been reported with other inhibitors of angiotensin-converting enzyme (mostly captopril), but this is the first case of an important adverse reaction to fosinopril. |
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