Danazol induced acute icteric cholestatic hepatitis

Kalliopi Petraki, S. Hadziyannis, Petros I. Rafailidis, Spyridon P. Dourakis
In: Annals of Gastroenterology · 2007 · vol. 16(1) · W1934243632
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This case report details a male patient who developed acute icteric cholestatic hepatitis five months after starting danazol therapy for idiopathic thrombocytopenic purpura, which resolved upon drug withdrawal.

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Abstract

SUMMARY Though asymptomatic elevation of aminotransferases is not infrequently caused by danazol, clinical evidence of liver disease is extremely rare. The spectrum of hepatic involvement is broad, including entities such as pure cholestasis, cholestatic hepatitis, cytolytic hepatitis, peliosis hepatis hepatic adenoma and hepatocellular carcinoma. We describe the case of a male patient who was treated with danazol for idiopathic thrombocytopenic purpura and presented with jaundice, pruritus and discolouration of urine and faeces five months after therapy started. Percutaneous liver biopsy disclosed acute cholestasis and concurrent mild hepatocellular damage. Other common causes of cholestasis were ruled out. On danazol withdrawal he improved clinically and bilirubin levels returned to normal after sixteen weeks. This is the fourth case in the world literature of danazol associated with acute icteric cholestatic hepatitis. As this clinical spectrum can mimic the constellation of symptoms and signs due to obstructive jaundice, bearing the aforementioned association in mind helps to avoid unnecessary investigations. Keywords: danazol, hepatitis, cholestasis, drug induced liver disease.

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