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Vanishing bile duct syndrome: case report A 31-year-old woman with a history of poor seizure control since childhood presented with abnormal liver function tests and symptoms of mild fatigue and pruritus. An ultrasound revealed normal biliary ducts and cholelithiasis. Endoscopic ultrasound and endoscopic retrograde cholangiopancreatography revealed no biliary ductal abnormalities. Liver biopsy revealed an absence of bile ducts and mild periportal fibrosis. Her medications included phenobarbital and carbamazepine [routes, dosages and duration of treatment to reaction onset not stated]. She was diagnosed with vanishing bile duct syndrome. Carbamazepine and phenobarbital were discontinued and she received ursodeoxycholic acid; her liver function tests subsequently improved. Author comment: "This case illustrates an occurence of vanishing bile duct syndrome as a result of the medications [carbamazepine] and/or phenobarbital." Hiatt T, et al. Anti-Epileptic Medications and Vanishing Bile Duct Syndrome: A Rare but Clinically Relevant Association. 75th Annual Scientific Meeting of the American College of Gastroenterology : abstr. P171, 15 Oct 2010. Available from: 803042899 URL: http://www.acg.gi.org - USA

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Reactions 30 Oct 2010 No. 1325