Acute hepatitis with prolonged cholestasis and disappearance of interlobular bile ducts following tibolone and Hypericum perforatum (St. John's wort). Case of drug interaction?

Etogo-Asse, F;Boemer, F;Sempoux, Christine;Geubel, André
(2008) Acta Gastro-Enterologica Belgica (Multilingual Edition) — Vol. 71, n° 1, p. 36-38 (2008)

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Authors
  • Etogo-Asse, F
    Author
  • Boemer, F
    Author
  • Sempoux, ChristineUCLouvain
    Author
  • Geubel, AndréUCLouvain
    Author
Abstract
The case of a patient under tibolone therapy for two years who developed a mixed-type liver injury with prolonged cholestasis and features of the vanishing bile duct syndrome following a ten weeks treatment with St. John wort (Hypericum Perforatum) infusions is reported. In the absence of evidence of a potential role for concomitant medication i.e. hydroxychloroquine sulfate to play a role in the clinical, biochemical and morphological picture, an interaction between the herbal preparation and tibolone was suspected as the likely cause of liver damage.
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Etogo-Asse, F., Boemer, F., Sempoux, C., & Geubel, A. (2008). Acute hepatitis with prolonged cholestasis and disappearance of interlobular bile ducts following tibolone and Hypericum perforatum (St. John’s wort). Case of drug interaction? Acta Gastro-Enterologica Belgica (Multilingual Edition), 71(1), 36-38. https://hdl.handle.net/2078.5/209618 (Original work published 2008)