RESUMEN
The effect of metronidazole on liver function tests was studied in patients given total parenteral nutrition (TPN) for an acute attack of Crohn's disease. In those receiving TPN and metronidazole, serum activities of alkaline phosphatase and gamma-glutamyl-transferase decreased or remained normal after 30 days of TPN. In contrast, serum activities of these enzymes increased significantly after 30 days of TPN alone. These results suggest that intrahepatic cholestasis associated with TPN may be related to intestinal overgrowth of anaerobic bacteria.
Asunto(s)
Colestasis Intrahepática/prevención & control , Metronidazol/uso terapéutico , Nutrición Parenteral Total/efectos adversos , Nutrición Parenteral/efectos adversos , Enfermedad Aguda , Anaerobiosis , Bacterias/efectos de los fármacos , Colestasis Intrahepática/etiología , Enfermedad de Crohn/terapia , Femenino , Humanos , Intestinos/microbiología , Hígado/fisiopatología , Pruebas de Función Hepática , Masculino , Metronidazol/farmacologíaRESUMEN
The occurrence of solitary liver abscess is described in a young farmer with subacute terminal ileitis mimicking Crohn's disease. Serologic tests showed high titers of antibodies for Yersinia pseudotuberculosis. Treatment with troleandomycin was successful. This case report suggests that: (a) Yersinia infection must be systematically searched for in all forms of subacute ileitis; (b) a classically benign Yersinia ileitis may be complicated by liver abscess; (c) antibiotic therapy must be undertaken in Yersinia pseudotuberculosis subacute ileitis to avoid severe infectious complications.