[Show abstract][Hide abstract]ABSTRACT: We report a case of severe hepatotoxicity associated with ductopenia in a 61-year-old woman. The patient developed jaundice, vomiting, and abdominal pain a few weeks after the beginning of treatment with candesartan cilexetil, 16 mg/d, for essential hypertension. Liver biopsy showed parenchymal bilirubinostasis with portal cholangitis and ductopenia. The drug was immediately withdrawn, and in the following weeks, aminotransferases and serum bilirubin returned to normal levels. The clinical-histologic data and the exclusion of known causes of liver disease led us to make a diagnosis of drug-induced cholestasis. To our knowledge, this is the first description of severe hepatotoxicity associated with ductopenia caused by an adverse reaction to candesartan cilexetil.
No preview · Article · Apr 2003 · Journal of Clinical Gastroenterology
[Show abstract][Hide abstract]ABSTRACT: Permanent pacemaker (PM) is implanted to prevent or to treat bradycardia caused by disorders of the cardiac conduction system. Normal aging is associated with changes in the conduction system and therefore the incidence and prevalence of arrhythmias increase with aging. Consequently, PM implantation rate is higher in the elderly than in other population groups, although only few cases of PM-use in patients over 100 years are reported in the literature. A 102-year-old woman, suffering from lipothymial attacks for a week, was admitted to our division. Her blood pressure was 140/60 mmHg, and heart rate was 30 b/m. The electrocardiogram showed second degree AV block 2:1; consequently, our patient underwent a permanent insertion of a single-chamber ventricular PM (VVI). Symptoms were resolved promptly after the PM implantation and there was no evidence of new episodes of lipothymial attacks. No alterations were found during the follow-up period. One year later our patient is still alive. Our conclusive message is that even in frail patients aged 100 years and older, PM implantation significantly prolongs life and improves its quality, with a low operative risk.
No preview · Article · Feb 2002 · Archives of gerontology and geriatrics. Supplement