Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso

A 66 year-old obese woman with arthrosis, self-medicated with oral nimesulide, 200 mg daily. After 6 weeks she developed nausea, jaundice and dark urine. Two weeks later she had recurrent hematemesis and was hospitalized. Besides obesity and anemia her physical examination was unremarkable. An upper...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Tejos C,Sergio, Torrejón S,Nancy, Reyes B,Humberto, Meneses C,Manuel
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2000
Materias:	Anti-inflammatory agents, non-Steroidal Hepatitis, toxic Peptic, ulcer
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000001200007
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:scielo:S0034-98872000001200007
record_format	dspace
spelling	oai:scielo:S0034-988720000012000072001-02-08Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un casoTejos C,SergioTorrejón S,NancyReyes B,HumbertoMeneses C,Manuel Anti-inflammatory agents, non-Steroidal Hepatitis, toxic Peptic, ulcer A 66 year-old obese woman with arthrosis, self-medicated with oral nimesulide, 200 mg daily. After 6 weeks she developed nausea, jaundice and dark urine. Two weeks later she had recurrent hematemesis and was hospitalized. Besides obesity and anemia her physical examination was unremarkable. An upper GI endoscopy revealed 3 acute gastric ulcers and a 4th one in the pyloric channel. Abdominal ultrasonogram showed a slightly enlarged liver with diffuse reduction in ecogenicity; the gallbladder and biliary tract were normal. Blood tests demonstrated a conjugated hyperbilirubinemia (maximal total value: 18,4 mg/dl), ALAT 960 U/l, ASAT 850 U/l, GGT 420 U/l, alkaline phosphatases mildly elevated, pro-time 49% and albumin 2.7 mg/dl. Serum markers for hepatitis A, B and C viruses were negative. ANA, AMA, anti-SmA, were negative. Ceruloplasmin was normal. A liver biopsy showed bridging necrosis and other signs of acute toxic liver damage. Gastric ulcers healed after conventional treatment and hepatitis subsided after 2 months leaving no signs of chronic liver damage. The diagnosis of toxic hepatitis due to nimesulide was supported by the time-course of drug usage, sex, age, absence of other causes of liver disease, a compatible liver biopsy and the improvement after drug withdrawal. Peptic ulcers or toxic hepatitis have been previously described as independent adverse reactions in patients taking nimesulide or other NSAIDs but their simultaneous occurrence in a single patient is a unique event that deserves to be reported (Rev Méd Chile 2000; 128: 1349-53).info:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.128 n.12 20002000-12-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000001200007es10.4067/S0034-98872000001200007
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
topic	Anti-inflammatory agents, non-Steroidal Hepatitis, toxic Peptic, ulcer
spellingShingle	Anti-inflammatory agents, non-Steroidal Hepatitis, toxic Peptic, ulcer Tejos C,Sergio Torrejón S,Nancy Reyes B,Humberto Meneses C,Manuel Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
description	A 66 year-old obese woman with arthrosis, self-medicated with oral nimesulide, 200 mg daily. After 6 weeks she developed nausea, jaundice and dark urine. Two weeks later she had recurrent hematemesis and was hospitalized. Besides obesity and anemia her physical examination was unremarkable. An upper GI endoscopy revealed 3 acute gastric ulcers and a 4th one in the pyloric channel. Abdominal ultrasonogram showed a slightly enlarged liver with diffuse reduction in ecogenicity; the gallbladder and biliary tract were normal. Blood tests demonstrated a conjugated hyperbilirubinemia (maximal total value: 18,4 mg/dl), ALAT 960 U/l, ASAT 850 U/l, GGT 420 U/l, alkaline phosphatases mildly elevated, pro-time 49% and albumin 2.7 mg/dl. Serum markers for hepatitis A, B and C viruses were negative. ANA, AMA, anti-SmA, were negative. Ceruloplasmin was normal. A liver biopsy showed bridging necrosis and other signs of acute toxic liver damage. Gastric ulcers healed after conventional treatment and hepatitis subsided after 2 months leaving no signs of chronic liver damage. The diagnosis of toxic hepatitis due to nimesulide was supported by the time-course of drug usage, sex, age, absence of other causes of liver disease, a compatible liver biopsy and the improvement after drug withdrawal. Peptic ulcers or toxic hepatitis have been previously described as independent adverse reactions in patients taking nimesulide or other NSAIDs but their simultaneous occurrence in a single patient is a unique event that deserves to be reported (Rev Méd Chile 2000; 128: 1349-53).
author	Tejos C,Sergio Torrejón S,Nancy Reyes B,Humberto Meneses C,Manuel
author_facet	Tejos C,Sergio Torrejón S,Nancy Reyes B,Humberto Meneses C,Manuel
author_sort	Tejos C,Sergio
title	Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
title_short	Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
title_full	Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
title_fullStr	Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
title_full_unstemmed	Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
title_sort	ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso
publisher	Sociedad Médica de Santiago
publishDate	2000
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872000001200007
work_keys_str_mv	AT tejoscsergio ulcerasgastricassangrantesyhepatitisagudadosreaccionesadversassimultaneaspornimesulidaenuncaso AT torrejonsnancy ulcerasgastricassangrantesyhepatitisagudadosreaccionesadversassimultaneaspornimesulidaenuncaso AT reyesbhumberto ulcerasgastricassangrantesyhepatitisagudadosreaccionesadversassimultaneaspornimesulidaenuncaso AT menesescmanuel ulcerasgastricassangrantesyhepatitisagudadosreaccionesadversassimultaneaspornimesulidaenuncaso
_version_	1718435948768788480

Ulceras gástricas sangrantes y hepatitis aguda: dos reacciones adversas simultáneas por nimesulida, en un caso

Ejemplares similares