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Cholestatic and hepatocellular injury associated with erythromycin esters

Report of nine cases

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Abstract

A combined cholestatic and hepatocellular injury occurred in nine patients, following therapy with erythromycin estolate (EE) or other erythromycin derivatives. Eight of the nine patients developed jaundice within three weeks after initiation of treatment; pain was one of the main symptoms in five patients while fever and itching were noted in four patients. Symptoms and signs subsided and abnormal tests of liver function returned to normal after withdrawal of the drug. The major histologic finding was cholestasis, but the majority of cases also had evidence of hepatocellular injury of variable severity; one biopsy specimen showed centrilobular necrosis. Ultrastructural findings in one case included changes related to cholestasis as well as hepatocellular injury with striking mitochondrial abnormalities. Our data are compared with those of the literature, with special reference to morphologic features.

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Authors and Affiliations

  1. Department of Hepatic Pathology, Armed Forces Institute of Pathology, 20306, Washington, D.C.

    Elie S. Zafrani MD,  Kamal G. Ishak MD & Cesar Rudzki MD

  2. George Washington University, 20306, Washington, D.C.

    Elie S. Zafrani MD,  Kamal G. Ishak MD & Cesar Rudzki MD

Authors
  1. Elie S. Zafrani MD
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  2. Kamal G. Ishak MD
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  3. Cesar Rudzki MD
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The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as representing the views of the Departments of Army and Defense.

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Zafrani, E.S., Ishak, K.G. & Rudzki, C. Cholestatic and hepatocellular injury associated with erythromycin esters. Digest Dis Sci 24, 385–396 (1979). https://doi.org/10.1007/BF01297126

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