Abstract
History:
A 46-year-old woman presented for an emergency admission because of colic-like upper abdominal pain and markedly impaired general condition. Eight days before admission she had started and continued to take pantoprazole because of symptoms of gastroesophageal reflux.
Investigations:
Clinical examination and laboratory tests indicated abnormal liver functions suggesting hepatitis. Serology largely excluded an infectious, autoimmunological or metabolic cause. Duplex sonography gave no evidence of bile obstruction or Budd-Chiari syndrome.
Diagnosis and course:
The patient's condition and laboratory tests after the drug had been discontinued gradually improved on symptomatic treatment, indicating pantoprazole-induced hepatitis.
Conclusion:
Intake of proton pump inhibitors is a rare cause but should be considered in the differential diagnosis of hepatitis of uncertain etiology.
MeSH terms
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2-Pyridinylmethylsulfinylbenzimidazoles
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Abdomen / diagnostic imaging
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Abdominal Pain / chemically induced
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Anti-Ulcer Agents / adverse effects*
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Anti-Ulcer Agents / therapeutic use
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Benzimidazoles / adverse effects*
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Benzimidazoles / therapeutic use
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Chemical and Drug Induced Liver Injury / diagnosis
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Chemical and Drug Induced Liver Injury / etiology*
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Chemical and Drug Induced Liver Injury / therapy
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Diagnosis, Differential
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Enzyme Inhibitors / adverse effects*
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Enzyme Inhibitors / therapeutic use
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Female
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Gastroesophageal Reflux / drug therapy
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Humans
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Liver / blood supply
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Liver / diagnostic imaging
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Liver / drug effects
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Middle Aged
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Omeprazole / analogs & derivatives
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Pantoprazole
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Proton Pump Inhibitors*
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Sulfoxides / adverse effects*
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Sulfoxides / therapeutic use
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Ultrasonography, Doppler, Duplex
Substances
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2-Pyridinylmethylsulfinylbenzimidazoles
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Anti-Ulcer Agents
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Benzimidazoles
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Enzyme Inhibitors
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Proton Pump Inhibitors
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Sulfoxides
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Pantoprazole
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Omeprazole