Acute hepatocellular and cholestatic injury during therapy with hydrochlorothiazide - clinicohistopathologic findings: A case report

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Abstract

Introduction: Hydrochlorothiazide and thiazide-like diuretics are considered first-line drugs for initial therapy in uncomplicated arterial hypertension. Acute cholecystitis is a well-known complication during treatment with thiazide, and these drugs are also reported to be followed by pronounced insulin resistance. Case Presentation: We describe a case of acute cholestatic hepatitis in a 68-year-old Caucasian man who was receiving olmesartan and hydrochlorothiazide for arterial hypertension. From the clinical and histologic findings, we diagnosed him as having hepatocellular-cholestatic injury and a disorder of glucose metabolism in the liver. To the best of our knowledge, no histopathologic description of hydrochlorothiazide hepatotoxicity has previously been documented in the literature. Conclusion: In the differential diagnosis of cholestatic hepatitis, clinicians should be aware of the possibility of liver damage in patients receiving hydrochlorothiazide therapy.

Original languageEnglish
Pages (from-to)332
Number of pages1
JournalJournal of Medical Case Reports
DOIs
Publication statusAccepted/In press - Oct 21 2010

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Hydrochlorothiazide
Wounds and Injuries
Hepatitis
Glucose Metabolism Disorders
Hypertension
Thiazides
Sodium Chloride Symporter Inhibitors
Acute Cholecystitis
Liver
Therapeutics
Insulin Resistance
Differential Diagnosis
Drug Therapy
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Medicine(all)

Cite this

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title = "Acute hepatocellular and cholestatic injury during therapy with hydrochlorothiazide - clinicohistopathologic findings: A case report",
abstract = "Introduction: Hydrochlorothiazide and thiazide-like diuretics are considered first-line drugs for initial therapy in uncomplicated arterial hypertension. Acute cholecystitis is a well-known complication during treatment with thiazide, and these drugs are also reported to be followed by pronounced insulin resistance. Case Presentation: We describe a case of acute cholestatic hepatitis in a 68-year-old Caucasian man who was receiving olmesartan and hydrochlorothiazide for arterial hypertension. From the clinical and histologic findings, we diagnosed him as having hepatocellular-cholestatic injury and a disorder of glucose metabolism in the liver. To the best of our knowledge, no histopathologic description of hydrochlorothiazide hepatotoxicity has previously been documented in the literature. Conclusion: In the differential diagnosis of cholestatic hepatitis, clinicians should be aware of the possibility of liver damage in patients receiving hydrochlorothiazide therapy.",
author = "Fabrizio Taglietti and {Del Nonno}, Franca and Andrea Baiocchini and Laura Falasca and Stefano Pieri and Alessandro Capone and Elisabetta Grilli and Pierangelo Chinello and Nicola Petrosillo",
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T1 - Acute hepatocellular and cholestatic injury during therapy with hydrochlorothiazide - clinicohistopathologic findings

T2 - A case report

AU - Taglietti, Fabrizio

AU - Del Nonno, Franca

AU - Baiocchini, Andrea

AU - Falasca, Laura

AU - Pieri, Stefano

AU - Capone, Alessandro

AU - Grilli, Elisabetta

AU - Chinello, Pierangelo

AU - Petrosillo, Nicola

PY - 2010/10/21

Y1 - 2010/10/21

N2 - Introduction: Hydrochlorothiazide and thiazide-like diuretics are considered first-line drugs for initial therapy in uncomplicated arterial hypertension. Acute cholecystitis is a well-known complication during treatment with thiazide, and these drugs are also reported to be followed by pronounced insulin resistance. Case Presentation: We describe a case of acute cholestatic hepatitis in a 68-year-old Caucasian man who was receiving olmesartan and hydrochlorothiazide for arterial hypertension. From the clinical and histologic findings, we diagnosed him as having hepatocellular-cholestatic injury and a disorder of glucose metabolism in the liver. To the best of our knowledge, no histopathologic description of hydrochlorothiazide hepatotoxicity has previously been documented in the literature. Conclusion: In the differential diagnosis of cholestatic hepatitis, clinicians should be aware of the possibility of liver damage in patients receiving hydrochlorothiazide therapy.

AB - Introduction: Hydrochlorothiazide and thiazide-like diuretics are considered first-line drugs for initial therapy in uncomplicated arterial hypertension. Acute cholecystitis is a well-known complication during treatment with thiazide, and these drugs are also reported to be followed by pronounced insulin resistance. Case Presentation: We describe a case of acute cholestatic hepatitis in a 68-year-old Caucasian man who was receiving olmesartan and hydrochlorothiazide for arterial hypertension. From the clinical and histologic findings, we diagnosed him as having hepatocellular-cholestatic injury and a disorder of glucose metabolism in the liver. To the best of our knowledge, no histopathologic description of hydrochlorothiazide hepatotoxicity has previously been documented in the literature. Conclusion: In the differential diagnosis of cholestatic hepatitis, clinicians should be aware of the possibility of liver damage in patients receiving hydrochlorothiazide therapy.

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