Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease
Drugs are a significant cause of liver injury. Drug-induced liver injury (DILI) can cause acute hepatitis, cholestasis, or a mixed pattern. Ceftriaxone is a commonly used antibiotic and has been associated with reversible biliary sludge, pseudolithiasis, and cholestasis. A 32-year-old male with sick...
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| Format: | Article |
| Language: | English |
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Wiley
2015-01-01
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| Series: | Case Reports in Gastrointestinal Medicine |
| Online Access: | http://dx.doi.org/10.1155/2015/462165 |
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| author | Daniyeh Khurram Leonid Shamban Robert Kornas Maryann Paul |
| author_facet | Daniyeh Khurram Leonid Shamban Robert Kornas Maryann Paul |
| author_sort | Daniyeh Khurram |
| collection | DOAJ |
| description | Drugs are a significant cause of liver injury. Drug-induced liver injury (DILI) can cause acute hepatitis, cholestasis, or a mixed pattern. Ceftriaxone is a commonly used antibiotic and has been associated with reversible biliary sludge, pseudolithiasis, and cholestasis. A 32-year-old male with sickle cell disease was admitted to the hospital for acute sickle cell crisis. On the second day of hospitalization, he developed cough and rhonchi with chest X-ray revealing right middle lobe infiltrates. Ceftriaxone and azithromycin were initiated. Subsequently, he developed conjugated hyperbilirubinemia and mild transaminitis. His total bilirubin trended upwards from 3.3 mg/dL on admission to 17 mg/dL. It was predominantly conjugated bilirubin, with preadmission bilirubin levels of 3-4 mg/dL. His transaminases were mildly elevated as well compared to previous levels. Extensive workup for bilirubin elevation was unremarkable. Ceftriaxone was switched to levofloxacin and the hyperbilirubinemia improved. On ambulatory follow-up, his bilirubin remained below 4 mg/dL. Ceftriaxone may be associated with marked direct hyperbilirubinemia particularly in sickle cell patients with chronic liver chemistry abnormalities. In the case of elevated bilirubin with concomitant ceftriaxone use, elimination of the offending agent should be considered. |
| format | Article |
| id | doaj-art-2f66f85fe56f4d6f899c8fe0f4b6d234 |
| institution | Kabale University |
| issn | 2090-6528 2090-6536 |
| language | English |
| publishDate | 2015-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Gastrointestinal Medicine |
| spelling | doaj-art-2f66f85fe56f4d6f899c8fe0f4b6d2342025-02-03T01:20:28ZengWileyCase Reports in Gastrointestinal Medicine2090-65282090-65362015-01-01201510.1155/2015/462165462165Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell DiseaseDaniyeh Khurram0Leonid Shamban1Robert Kornas2Maryann Paul3Department of Internal Medicine, Providence Hospital and Medical Center, 16001 W. Nile Mile Road, Southfield, MI 48075, USADepartment of Internal Medicine, Providence Hospital and Medical Center, 16001 W. Nile Mile Road, Southfield, MI 48075, USADepartment of Internal Medicine, Providence Hospital and Medical Center, 16001 W. Nile Mile Road, Southfield, MI 48075, USADepartment of Internal Medicine, Providence Hospital and Medical Center, 16001 W. Nile Mile Road, Southfield, MI 48075, USADrugs are a significant cause of liver injury. Drug-induced liver injury (DILI) can cause acute hepatitis, cholestasis, or a mixed pattern. Ceftriaxone is a commonly used antibiotic and has been associated with reversible biliary sludge, pseudolithiasis, and cholestasis. A 32-year-old male with sickle cell disease was admitted to the hospital for acute sickle cell crisis. On the second day of hospitalization, he developed cough and rhonchi with chest X-ray revealing right middle lobe infiltrates. Ceftriaxone and azithromycin were initiated. Subsequently, he developed conjugated hyperbilirubinemia and mild transaminitis. His total bilirubin trended upwards from 3.3 mg/dL on admission to 17 mg/dL. It was predominantly conjugated bilirubin, with preadmission bilirubin levels of 3-4 mg/dL. His transaminases were mildly elevated as well compared to previous levels. Extensive workup for bilirubin elevation was unremarkable. Ceftriaxone was switched to levofloxacin and the hyperbilirubinemia improved. On ambulatory follow-up, his bilirubin remained below 4 mg/dL. Ceftriaxone may be associated with marked direct hyperbilirubinemia particularly in sickle cell patients with chronic liver chemistry abnormalities. In the case of elevated bilirubin with concomitant ceftriaxone use, elimination of the offending agent should be considered.http://dx.doi.org/10.1155/2015/462165 |
| spellingShingle | Daniyeh Khurram Leonid Shamban Robert Kornas Maryann Paul Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease Case Reports in Gastrointestinal Medicine |
| title | Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease |
| title_full | Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease |
| title_fullStr | Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease |
| title_full_unstemmed | Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease |
| title_short | Marked Direct Hyperbilirubinemia due to Ceftriaxone in an Adult with Sickle Cell Disease |
| title_sort | marked direct hyperbilirubinemia due to ceftriaxone in an adult with sickle cell disease |
| url | http://dx.doi.org/10.1155/2015/462165 |
| work_keys_str_mv | AT daniyehkhurram markeddirecthyperbilirubinemiaduetoceftriaxoneinanadultwithsicklecelldisease AT leonidshamban markeddirecthyperbilirubinemiaduetoceftriaxoneinanadultwithsicklecelldisease AT robertkornas markeddirecthyperbilirubinemiaduetoceftriaxoneinanadultwithsicklecelldisease AT maryannpaul markeddirecthyperbilirubinemiaduetoceftriaxoneinanadultwithsicklecelldisease |