Ultrastructural features of danazol-induced cholestasis: a case study

D Alvaro, Domenico Alvaro, Claudia Piat, C Piat, C Francia, Chiara Francia, A Franchitto, Antonio Franchitto, S. Furfaro, C Valente, Costanzo Valente, L. Capocaccia, E Gaudio, Eugenio Gaudio
Ultrastructural pathology · 1996 · vol. 20(5) , pp. 491–495 · doi:10.3109/01913129609016353 · PMID:8883334 · W1981956715
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This case study describes ultrastructural changes in a danazol-induced cholestatic syndrome, characterized by dilated bile canaliculi with altered microvilli and dense bile material, despite mild enzyme elevation.

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Abstract

A case study of a severe cholestatic syndrome induced by danazol, with ultrastructural description of liver morphology, is reported. Cholestasis appeared after 3 months treatment with danazol (300 mg/daily) and completely resolved 2 months after withdrawal. In spite of the severe increase in serum bilirubin and total serum bile salts, transaminases were only slightly elevated and GGT and alkaline phosphatases were almost normal. Light microscopy shows a pattern of predominantly centrolobular cholestasis without necrosis, with minimal inflammatory infiltrate and with no sign of bile ductule involvement. At the ultrastructural level very dilated bile canaliculus predominate with stunted or loss of microvilli and dense bile material in the lumen. Nonspecific alterations were seen in hepatocyte intracellular organelles. It is suggested that danazol may cause a rare but severe hepatocanalicular cholestasis, differing from the "bland" cholestasis frequently described during therapy with other anabolic steroids.

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MeSH descriptors

Cholestasis Danazol Liver Bilirubin Bilirubin Biopsy Cholestasis Cholestasis Cholestasis Danazol Female Humans Liver Liver Microscopy, Electron Middle Aged S-Adenosylmethionine S-Adenosylmethionine Time Factors Ursodeoxycholic Acid

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