The first report of atovaquone/proguanil-induced vanishing bile duct syndrome: Case report and mini-review. Issue 32 (November 2019)

• Record Type: Journal Article
• Authors: Abugroun, Ashraf; Colina Garcia, Ibett; Ahmed, Fatima; Potts, Steven; Flicker, Michael
• Is Part Of: Travel medicine and infectious disease. Issue 32(2019)
• Publication Date: 2019-11
• Subjects: Atovaquone-proguanil -- Vanishing bile duct syndrome -- Malaria; VBDS Vanishing bile duct syndrome -- AMA Anti-mitochondrial antibodies -- anti-LKM-1 liver kidney microsome type 1 -- ASMA Smooth muscle antibodies -- PCP Pneumocystis jirovecii pneumonia -- NSAID Nonsteroidal antiinflammatory drugs -- DHFR Dihydrofolate reductase; Travel -- Health aspects -- Periodicals; Communicable diseases -- Periodicals; Tropical medicine -- Periodicals; 610.5
• DOI: 10.1016/j.tmaid.2019.06.010
• Languages: English
• ISSNs: 1477-8939

Abstract

Abstract: The combination of Atovaquone and Proguanil (Malarone™) has been widely used for treatment and prevention of Plasmodium falciparum malaria. Transient elevation of liver enzymes is a recognized side effect of the medication. The association of Vanishing bile duct syndrome (VBDS) with the use of Atovaqoune/Proguanil was not previously reported. We describe a case of a 62-year-old male with no history of liver disease who presented with painless jaundice after receiving malaria prophylaxis with Atovaquone-proguanil for 25 days. The patient developed severe hepatitis with Vanishing bile duct syndrome. This case highlights a serious side effect of a usually well-tolerated medication.