Abstract
Trimethoprim/sulfamethoxazole is well known to cause intra-hepatic cholestasis which in rare instances can be prolonged and lead to vanishing bile duct syndrome. The risk regarding the potential for cross-reactivity between structurally related molecules such as dapsone and trimethoprim/sulfamethoxazole in causing hepatotoxicity is scarce. Herein, we report a case of vanishing bile duct syndrome following dapsone use in a patient with HIV infection and a recent history of trimethoprim/sulfamethoxazole-induced cholestasis. The patient had severe and protracted cholestasis during 2 years of follow-up and eventually died of liver failure.
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Acknowledgements
We would like to acknowledge that this work was funded in part by a Grant provided to Dr. Fontana by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) to the University of Michigan (2U01-DK065184-06).
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Dr. Fontana has received Grant support from Gilead, BristolMyersSquibb, and Abbvie and provided consultation to Sanofi. Dr. Mutchnick has research Grants from Proteus and Gilead and also a Member of Speakers Bureau for Gilead, Abbvie, Intercept and Chronic Liver Disease Foundation. Financial disclosures for the remaining authors: None.
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Kathi, P.R., Tama, M., Ehrinpreis, M. et al. Vanishing bile duct syndrome arising in a patient with HIV infection sequentially treated with trimethoprim/sulfamethoxazole and dapsone. Clin J Gastroenterol 13, 276–280 (2020). https://doi.org/10.1007/s12328-019-01022-5
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DOI: https://doi.org/10.1007/s12328-019-01022-5