A case of cholestatic hepatitis associated with histologic features of acute cholangitis

Hajime Takeuchi¹, Toru Kaneko¹, Toshikazu Otsuka¹, Kumiko Tahara¹, Tadashi Motoori², Makoto Ohbu³, Masaya Oda⁴, Hiroaki Yokomori^1
1Department of Internal Medicine; ²Division of Pathology, Kitasato Medical Center Hospital, Kitasato University, Saitama; ³Department of Pathology, School of Allied Health Sciences, Kitasato University, Sagamihara, Kanagawa; ⁴Department of Internal Medicine, Saitama Social Insurance Hospital, Saitama; ⁵Organized Center of Clinical Medicine, International University of Health and Welfare, Sanno Hospital, Tokyo, Japan

Abstract: This report describes a case showing histologic features of acute cholangitis with an over-the-counter drug. A 48-year-old woman was diagnosed with general malaise and progressive jaundice. A thorough review of her medical history revealed that the patient had taken an over-the-counter drug, Pabron Gold^®, which she had used previously, that may have caused liver injury. Laboratory investigations revealed jaundice and liver dysfunction. Endoscopic retrograde cholangiography detected no extrahepatic biliary duct dilatation or stones. Liver biopsy indicated acute cholangitis involving neutrophils and eosinophils. Electron microscopy revealed fragmented nuclei, indicating that the degenerative bile duct-related epithelial cells were in an apoptotic process.

Keywords: liver injury, over-the-counter drug, histologic features, acute cholangitis, electron microscopy, Pabron Gold