minocycline and Jaundice--Obstructive

The authors describe the case of a small liver cyst (2 cm in diameter) causing obstructive jaundice that was treated with aspiration and therapeutic sclerosis. The procedure was performed with use of a microcatheter and wire system to access the cyst, which was injected with minocycline hydrochloride. At present, 9 months after treatment, the levels of hepatobiliary enzymes are within normal ranges, and no sign of cyst regrowth has been detected on imaging.

Topics: Aged; Catheterization; Catheters; Cholangiopancreatography, Endoscopic Retrograde; Combined Modality Therapy; Cysts; Drainage; Equipment Design; Female; Humans; Injections; Jaundice, Obstructive; Liver Diseases; Miniaturization; Minocycline; Sclerosing Solutions; Sclerotherapy; Tomography, X-Ray Computed; Treatment Outcome

We report a case of Chlamydophila (C.) pneumoniae infection presenting with fever and rapid intrahepatic cholestasis. A 63-year-old man had a week-long history of intermittent high fever and rapidly progressive jaundice with atypical erythema. The results of liver function tests were recorded. The results of all serological tests were negative; the IgM, IgG, and IgA titers for C. pneumoniae had increased, which indicates a C. pneumoniae infection. The patient's fever and liver dysfunction improved upon administration of minocycline. Light microscopic findings showed the presence of enlarged liver cells with clear cytoplasm, a few mitotic figures, multinucleated cells, and bile cholestasis. The electron microscopic appearance of liver biopsy showed that bile canaliculi exhibited intrahepatic forms of cholestasis. From the results of light and electron microscopy, we inferred atypical intrahepatic cholestasis, probably resulting from the C. pneumoniae infection.

Topics: Alanine Transaminase; Anti-Bacterial Agents; Antibodies, Bacterial; Aspartate Aminotransferases; Chlamydophila Infections; Chlamydophila pneumoniae; Cholestasis, Intrahepatic; Erythema Nodosum; Fever; Humans; Jaundice, Obstructive; Liver; Lung; Male; Middle Aged; Minocycline

A 64-year-old man with a 9.0 cm benign hepatic cyst near the hepatic hilum presented with obstructive jaundice caused by the compression of the hepatic ducts. The cyst was aspirated percutaneously, and minocycline hydrochloride was instilled as a sclerosant through a catheter inserted into the cyst. The cyst gradually became smaller, relieving the obstructive jaundice. There were no complications or side-effects. The instillation of minocycline hydrochloride is a useful alternative to ethanol instillation for treating benign hepatic cysts, even when the cyst is causing obstructive jaundice.

Topics: Administration, Cutaneous; Catheterization; Cysts; Drainage; Humans; Jaundice, Obstructive; Liver Diseases; Male; Middle Aged; Minocycline; Tomography, X-Ray Computed

Minocycline is an effective treatment of acne vulgaris, especially for inflammatory forms. Prescription rates have increased in recent years accompanied by a number of reports concerning drug-induced side effects. An otherwise healthy woman developed an erythema multiform-like rash and and toxic hepatic damage causing cholestatic jaundice following long-term minocycline use. Unusual cutaneous lipid deposition also developed. Minocycline-induced side effects are reviewed.

Topics: Acne Vulgaris; Adult; Anti-Bacterial Agents; Biopsy; Erythema Multiforme; Female; Follow-Up Studies; Humans; Jaundice, Obstructive; Liver; Minocycline; Skin; Time Factors; Xanthomatosis