Jiménez-Luévano MÁ, Rodríguez-Villa P, Ramírez-Flores S, Jiménez-Partida M, Orozco-Chávez E, Aguilar-Rodríguez R, Riggen-Martínez L, Félix-Guzmán A, Ramírez-Jaimez J, Franco-Topete R, León-Escobedo S, Gutiérrez-Medrano M, Bravo-Cuellar A

Language: Spanish
References: 31
Page: 99-105
PDF size: 315.18 Kb.

ABSTRACT

Introduction. Cholestatic hepatitis is a rare entity characterized by a bile flow obstruction,and it has a multi-factorial etiology. It can be acute or chronic and occasionally triggers fibrosis, cirrhosis and severe hepatitis. The current pharmacological management is based on corticosteroids and azathioprine or other drugs, such as, methotrexate, cyclosporine, budesonide, ursodeoxycholic acid, mefenamic acid, and pentoxifylline (PTX). We report two patients with autoimmune cholestatic hepatitis treated with pentoxifylline.
Clinical cases. Two cases with diagnosis of cholestatic hepatitis confirmed by ultrasound and serological and histological studies. In both cases, corticosteroids were used as a pharmacological treatment without a favorable response. The therapy was replaced by pentoxifylline plus symptomatic treatment at base of ursodeoxycholic acid, vitamin E and cholestyramine. Both patients showed a remarkable improvement after two weeks of treatment. One of the patients showed a total bilirubin of 22.30 mg/dL with a decreased of direct bilirubin from 22.23 mg/dL to 2.10 mg/dL; meanwhile, the second patient showed a total bilirubin of 63.7 mg/dL with a decreased of direct bilirubin levels from 60.2 mg/dL to 2.33 mg/dL. In both patients the levels of transaminases decreased and an improvement of their clinical conditions were observed.
Discussion. Our results showed that there was a favorable response in two patients treated with pentoxifylline. This drug has anti-inflammatory, anti-oxidant and anti-fibrotic effects as well as inhibitors effects of the transcription factor NF- κβ , so that it could be considered as an alternative treatment in patients with cholestatic hepatitis after validating its actual effectiveness.

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