Cholestatic jaundice after triacetyloleandomycin and oral contraceptives. The diagnostic value of gamma-glutamyl transpeptidase.

Abstract

This article describes 4 patients who had been taking (OCs) oral contraceptives for between 1.5 and 2.5 years without incident. Treatment with (TAO) triacetyloleandomycin of these women on OCs caused obstructive jaundice after 1 week. This jaundice had the biological and histological features of intrahepatic cholestasis due to sterioids. An important diagnostic clue in all patients was the discrepancy between high alcaline phosphatase and normal or almost normal gamma-glutamyl transpeptidase. Jaundice disappeared after stopping TAO and the pill. When 2 of the patients were later challenged with OCs they tolerated the drug perfectly and did not show any signs of liver damage. Perhaps TAO by a mechanism still unknown facilitates the development of intrahepatic cholestasis in women taking OCs who tolerate the pill well as long as it is not associated with TAO. (Authors modified) (Summaries in FRE FLE)