Reactions 1704, p319 - 2 Jun 2018 Idiopathic jaundice aggravated to cholestatic jaundice: case report A 72-year-old man developed cholestatic jaundice (aggravation of the pre-existing idiopathic jaundice) following treatment with prednisone for paraneoplastic syndrome. The man had paraneoplastic syndrome along with prostate cancer. He visited an emergency department with anorexia and jaundice that had persisted for two months. Liver function tests revealed serum bilirubin of 13.1 mg/dL, serum albumin of 4.45 g/dL, APT of 112 IU/L, ALT of 146 IU/L. An abdominal CT showed enlargement of the prostate gland. The serum prostate-specific antigen level was as high as 7,895 ng/mL. The prostate biopsy showed adenocarcinoma, and a liver biopsy demonstrated a canalicular type of cholestasis. He received supportive care for 20 days, but his serum bilirubin did not improve. He received prednisone 40mg for three days following which the deterioration of the jaundice was noted. The cholestatic jaundice (aggravation of the pre-existing idiopathic jaundice) was considered to be related to The man’s treatment with prednisone was discontinued. His serum bilirubin level increased to 25.25 mg/dL. He was treated with antiandrogen therapy, along with bicalutamide and goserelin. Six days later, his jaundice improved, and the serum bilirubin level decreased to 7.22 mg/dL. Three months after the hormone therapy, his serum prostate-specific antigen level decreased from 7,895 ng/mL to 311 ng/mL, and his bilirubin level was normalised. Author comment: "Although steroids can be used as treatment in patients with prostate cancer, they could exacerbate paraneoplastic jaundice. The jaundice that flared up after treatment with 40 mg prednisone was improved with antiandrogen treatment." Kang MK, et al. Cholestatic Jaundice as a Paraneoplastic Manifestation of Prostate Cancer Aggravated by Steroid Therapy. Medical Principles and Practice 27: 197-200, No. 2, May 2018. Available from: URL: http:// doi.org/10.1159/000486717 - South Korea 803323775 0114-9954/18/1704-0001/$14.95 Adis © 2018 Springer International Publishing AG. All rights reserved Reactions 2 Jun 2018 No. 1704
Reactions Weekly – Springer Journals
Published: Jun 2, 2018
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