The first report of atovaquone/proguanil-induced vanishing bile duct syndrome: Case report and mini-review

Ashraf Abugroun; Ibett Colina Garcia; Fatima Ahmed; Steven Potts; Michael Flicker

doi:10.1016/j.tmaid.2019.06.010

The first report of atovaquone/proguanil-induced vanishing bile duct syndrome: Case report and mini-review

Travel Med Infect Dis. 2019 Nov-Dec:32:101439. doi: 10.1016/j.tmaid.2019.06.010. Epub 2019 Jun 22.

Authors

Ashraf Abugroun¹, Ibett Colina Garcia², Fatima Ahmed², Steven Potts², Michael Flicker³

Affiliations

¹ Department of Internal Medicine, Advocate Illinois Masonic Medical Center, USA. Electronic address: ashraf.abugroun@advocatehealth.com.
² Department of Internal Medicine, Advocate Illinois Masonic Medical Center, USA.
³ Department of Gastroenterology, Advocate Illinois Masonic Medical Center, USA.

PMID: 31238106
DOI: 10.1016/j.tmaid.2019.06.010

Abstract

The combination of Atovaquone and Proguanil (Malarone™) has been widely used for treatment and prevention of Plasmodium falciparum malaria. Transient elevation of liver enzymes is a recognized side effect of the medication. The association of Vanishing bile duct syndrome (VBDS) with the use of Atovaqoune/Proguanil was not previously reported. We describe a case of a 62-year-old male with no history of liver disease who presented with painless jaundice after receiving malaria prophylaxis with Atovaquone-proguanil for 25 days. The patient developed severe hepatitis with Vanishing bile duct syndrome. This case highlights a serious side effect of a usually well-tolerated medication.

Keywords: Atovaquone-proguanil; Malaria; Vanishing bile duct syndrome.

Publication types

Review