Abstract
Norethisteron is a progesterone-only oral contraceptive OCS that is widely used in some gynecological disorders. The side effects of the drug are nausea, vomiting, thromboembolia and hypertension, however rarely do these lead to cholestasis. We present a 42-year-old female patient admitted with fatigue, jaundice, dark urine, itching subsequent to use of norethisteron for amenorrhea. Due to sustained elevation of bilirubin and cholestasis enzymes, the patient underwent a liver biopsy. Histopathologic examination revealed canalicular cholestasis which is usually observed subsequent to administration of steroidal drugs. The patient responded well to steroid administration, and clinical and biochemical recovery were achieved on the 6th month of therapy
Keywords
References
- Kreek MJ. Female sex steroids and cholestasis. Semin Liver Dis 1987; 7:8–23.
- Anand V, Gorard DA. Norethisterone-induced cholestasis. OJM 2005; 98: 232-4.
- Dokmeci I. [Hipotalamo-hipofizer hormonlar ve cinsiyet hormonları]. Farmakoloji. 1. Baskı. Istanbul: Nobel Tip Kitabevi; 1992. p.483-522.
- Ergeneli MH, Zeyneloglu HB, Erdogan M. Reproduktif çağ kadınlarında kullanılan medroksiprogesteron asetat ve noretisteron yan etkilerinin karşılaştırılması. Türkiye Klinikleri J Gynecol Obst 1999; 9:276-80.
- Grimaud JC, Bourliere M. Contraception and Hepatogastroenterology. Fertil Contracept Sex 1989;17:407-13.
- Huang L, Smit JW, Meijer DK, Vore M. MRP 2 is essential for estradiol-17 beta (beta-D-glucuronide) – induced cholestasis in rats. Hepatology 2000; 32:66–72.
- Langlands AO, Martin WM. Jaundice associated with norethisterone- acetate treatment of breast cancer. Lancet 1975; 5:584–5.
- Foitl DR, Hyman G, Lefkowitch JH. Jaundice and intrahepatic cholestasis following high–dose megestrol acetate for breast cancer. Cancer 1989; 63:438–9.
- Zaki K, Rizk M, Kira L, Nour H, Guirguis R. Studies on the effects of ethinyl estradiol and norethisterone acetate on the adrenal cortex and some other tissues in the rat. Endokrinologie. 1979; 73:66–76.
- Lieberman DA, Keeffe EB, Stenzel P. Severe and prolonged oral contraceptive jaundice. J Clin Gastroenterology 1984; 2: 145-8.
- Goodman ZD. Drug hepatotoxicity. Clin Liver Dis 2002; 6:381-97.
- Topal F, Ozaslan E, Akbulut S, Kucukazman M. Metilprednisolone induced toxic hepatitis. Ann Pharmacother 2006; 40:1868-71.
- Seo JC, Jeon WJ, Park SS, Kim SH. Clinical experience of 48 acute toxic hepatitis patients. Korean J Hepatol 2006; 12: 74-81.
Abstract
Norethisteron bazı jinekolojik hastalıklarda kullanılan sadece progesteron içeren bir oral kontraseptiftir. Genellikle bulantı, kusma, tromboemboli ve hipertansiyona yol açmakla birlikte nadiren kolestaz tablosuna neden olur. Bu yazıda 42 yaşında amenore nedeniyle norethisteron kullanımına bağlı halsizlik, sarılık, koyu renkli idrar ve kaşıntı şikayeti ile başvuran bir kadın hasta sunulmuştur. Kolestaz enzimlerinde ve bilirubin düzeyinde yüksekliğin devam etmesi üzerine hastaya karaciğer biyopsisi yapıldı. Histopatolojik incelemesinde steroid grubu ilaçlarda görülebilecek kanaliküler kolestaz bulguları saptandı. Ampirik oral prednizolon tedavisi başlanan hastanın 6 ay içerisinde kliniğinde ve laboratuvar değerlerinde iyileşme görüldü
Keywords
References
- Kreek MJ. Female sex steroids and cholestasis. Semin Liver Dis 1987; 7:8–23.
- Anand V, Gorard DA. Norethisterone-induced cholestasis. OJM 2005; 98: 232-4.
- Dokmeci I. [Hipotalamo-hipofizer hormonlar ve cinsiyet hormonları]. Farmakoloji. 1. Baskı. Istanbul: Nobel Tip Kitabevi; 1992. p.483-522.
- Ergeneli MH, Zeyneloglu HB, Erdogan M. Reproduktif çağ kadınlarında kullanılan medroksiprogesteron asetat ve noretisteron yan etkilerinin karşılaştırılması. Türkiye Klinikleri J Gynecol Obst 1999; 9:276-80.
- Grimaud JC, Bourliere M. Contraception and Hepatogastroenterology. Fertil Contracept Sex 1989;17:407-13.
- Huang L, Smit JW, Meijer DK, Vore M. MRP 2 is essential for estradiol-17 beta (beta-D-glucuronide) – induced cholestasis in rats. Hepatology 2000; 32:66–72.
- Langlands AO, Martin WM. Jaundice associated with norethisterone- acetate treatment of breast cancer. Lancet 1975; 5:584–5.
- Foitl DR, Hyman G, Lefkowitch JH. Jaundice and intrahepatic cholestasis following high–dose megestrol acetate for breast cancer. Cancer 1989; 63:438–9.
- Zaki K, Rizk M, Kira L, Nour H, Guirguis R. Studies on the effects of ethinyl estradiol and norethisterone acetate on the adrenal cortex and some other tissues in the rat. Endokrinologie. 1979; 73:66–76.
- Lieberman DA, Keeffe EB, Stenzel P. Severe and prolonged oral contraceptive jaundice. J Clin Gastroenterology 1984; 2: 145-8.
- Goodman ZD. Drug hepatotoxicity. Clin Liver Dis 2002; 6:381-97.
- Topal F, Ozaslan E, Akbulut S, Kucukazman M. Metilprednisolone induced toxic hepatitis. Ann Pharmacother 2006; 40:1868-71.
- Seo JC, Jeon WJ, Park SS, Kim SH. Clinical experience of 48 acute toxic hepatitis patients. Korean J Hepatol 2006; 12: 74-81.
Details
| Primary Language | Turkish |
|---|---|
| Journal Section | Case Report |
| Authors | |
| Publication Date | June 1, 2014 |
| Published in Issue | Year 2014Issue: 2 |