Cholestatic hepatitis in association with celecoxibBMJ 2002; 325 doi: http://dx.doi.org/10.1136/bmj.325.7357.220 (Published 27 July 2002) Cite this as: BMJ 2002;325:220
Classification of drug associated liver dysfunction is questionable
- Faiyaz Mohammed, specialist registrar,
- Alastair D Smith, consultant gastroenterologist. ([email protected])
- Department of Medicine, Eastbourne District General Hospital, Eastbourne BN21 2UD
- Institute of Liver Studies, Kings College Hospital, London SE5 9RS
- Digestive Disease Centre, Royal Sussex County Hospital, Brighton BN2 5BE
EDITOR—We appreciated the report by O'Beirne and Cairns concerning a patient with liver test dysfunction in the setting of treatment with the COX 2 inhibitor celecoxib.1 We are, however, concerned at their use of “cholestatic hepatitis” as the most appropriate description of the pattern of liver test abnormality observed. The patient they described had a maximal aspartate transaminase concentration of 1650 IU/l (reference range 10-40 IU/l), a maximal alkaline phosphatase concentration of 232 IU/l (25-115 IU/l), and peak total serum bilirubin of 123 μmol/l (5-20 μmol/l).
In broad terms, two categories of drug associated liver injury are encountered commonly, namely cholestatic and hepatocellular.2 Cholestatic injury has been defined further as occurring when the …
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