non-ovlon and Cholestasis--Intrahepatic

A 25-year-old woman with progressive systemic sclerosis was treated with D-penicillamine. (DPA) 30 days after starting therapy cholestatic jaundice was observed. Moreover, for two years she has taken the pill. Both drugs were discontinued, the jaundice disappeared and the laboratory findings of liver became normal. A rechallenge of D-penicillamine after 9 months induced no reaction. An underlying chronic liver disease before cholestasis could be excluded by liver biopsy. Allergic cutantests and lymphocyte transformation test with D-penicillamine and penicillin gave normal results. The frequency of cholestatic jaundice caused by DPA-therapy is discussed and the possible pathomechanism analyzed.. A 25 year old woman with progressive systemic sclerosis was treated with D-penicillamine (DPA). 30 days after the initiation of therapy, cholestatic jaundice was observed. Moreover, for 2 years, the patient has taken the pill. Both drugs were discontinued, the jaundice disappeared, and the laboratory findings of the liver were normal. A rechallenge of DPA after 9 months induced no reaction. An underlying chronic liver disease before cholestasis could be excluded by liver biopsy. Allergic cutantests and lymphocyte transformation test with DPA and penicillin gave normal results. The frequency of cholestatic jaundice caused by DPA therapy is discussed and the possible pathomechanism is analyzed. (author's modified)

Topics: Adult; Alanine Transaminase; Bilirubin; Chlormadinone Acetate; Cholestasis, Intrahepatic; Contraceptives, Oral, Combined; Drug Combinations; Drug Therapy, Combination; Female; Humans; Norethindrone; Penicillamine; Scleroderma, Systemic