Plasmapheresis and corticosteroid treatment for persistent jaundice after successful drainage of common bile duct stones by endoscopic retrograde cholangiography

Saritas U. | Aydin B. | Ustundag Y.

Article | 2007 | World Journal of Gastroenterology13 ( 30 ) , pp.4152 - 4153

Prolonged cholestasis is a very rare complication of endoscopic retrograde cholangiography (ERC). Only few cases with this complication are reported in the English literature. We report persisting cholestatic jaundice in a 73-year old man after successful therapeutic ERC for choledocholithiasis. Serologic tests for viral and autoimmune hepatitis were all negative. A second-look ERC was normal also. He denied any medication except for prophylaxis given intravenous 1 g ceftriaxon prior to the ERC procedure. After an unsuccessful trial with ursodeoxycholic acid and cholestyramine for 2 wk, this case was efficiently treated with cortico . . .steroids and plasmapheresis. His cholestatic enzymes became normal and intense pruritis quickly resolved after this treatment which lasted during his follow-up period. We discussed the possible mechanisms and treatment alternatives of intrahepatic cholestasis associated with the ERC procedure. © 2007 WJG. All rights reserved Daha fazlası Daha az

Severe childhood amitriptyline intoxication and plasmapheresis: A case report

Karaci M. | Özçetin M. | Dilsiz G. | Güçlü-Songür Y.G.

Article | 2013 | Turkish Journal of Pediatrics55 ( 6 ) , pp.645 - 647

Tricyclic antidepressant intoxication is one of the most frequently encountered and life-threatening causes of intoxication among referrals to emergency departments due to drug intoxication. There is no known antidote against any of the tricyclic antidepressants. The American Society for Apheresis (ASFA) recommends plasmapheresis to support primary treatment in this type of drug poisoning, which does not respond to certain and traditional treatments. We present a 15-year-old girl who ingested amitriptyline with suicidal intent. On admission, she was in a comatose state (Glasgow Coma Scale score: 5), with no spontaneous respiration a . . .nd presence of pathological reflexes. Due to the intake history of lethal doses and the severe clinical picture, plasmapheresis was performed. She was discharged on her fifth day of hospitalization. Due to the high plasma protein binding property of amitriptyline, plasma exchange therapy should be considered in cases of severe amitriptyline intoxication as a life-saving therapeutic modality Daha fazlası Daha az

Treatment of severe amitriptyline intoxication with plasmapheresis

Kolsal, Ebru | Tekin, İshak Özel | Pişkin, Etem | Aydemir, Cumhur | Akyüz, Mehmet | Çabuk, Hasan | Eldes, Nilüfer | Numanoğlu, Kemal Varın

Article | 2009 | Journal of Clinical Apheresis24 ( 1 ) , pp.21 - 24

Tricyclic antidepressant poisoning is one of the most common causes of serious intoxication. Here, we report a 2-year-old girl with severe amitriptyline (70 mg/kg) intoxication. She was in comatose, had generalized tonic clonic seizure, ventricular tachycardia, and wide QRS complexes. Although she did not respond to classical therapies, very good clinical response to plasmapheresis was obtained and she developed no complications. Thus, plasmapheresis may be an effective treatment modality in poisoning with drugs, which bind to plasma proteins with high affinity. © 2009 Wiley-Liss, Inc.

Fulminant hepatic failure associated with propylthiouracil: A case report with treatment emphasis on the use of plasmapheresis

Aydemir S. | Ustundag Y. | Bayraktaroglu T. | Tekin I.O. | Peksoy I. | Unal A.U.

Article | 2005 | Journal of Clinical Apheresis20 ( 4 ) , pp.235 - 238

Propylthiouracil is a commonly used medication for hyperthyroidism. Though propylthiouracil-induced hepatotoxicity is a rarely encountered problem, death due to fulminant hepatic failure may occur. In the English literature, only 34 cases have been described with severe hepatotoxicity secondary to this drug. Here we report a case of fulminant hepatic failure due to propylthiouracil and review the issues of treatment and management with special emphasis on the use of plasmapheresis in such situations. © 2005 Wiley-Liss, Inc.

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