Doctors Publish Report Linking Zithromax to Liver Damage

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A recently published report by Hindawi Publishing Corporation looks into the risk of liver damage in women who take the antibiotic Zithromax. The report, entitled “A Case of Prolonged Cholestatic Hepatitis Induced by Azithromycin in a Young Woman,” suggests that liver damage from antibiotics like Zithromax is often underreported.

Commonly known as Zithromax or Z-Pak, azithromycin is a popular antibiotic that’s used to treat a myriad ailments. Six authors were behind this report, hailing from a number of esteemed departments including the University of Bologna’s Department of Clinical Medicine and Department of Internal Medicine. Edited by J. Genesca and F. Imazeki, the case study draws strong parallels between liver damage and the use of Zithromax.

The authors note that while reported links between liver damage and Z-Pak are relatively rare, “We here report the case of a prolonged cholestatic hepatitis after administration of azithromycin in a young woman with no history of liver disease.”

People of all ages are prescribed Z-Pak. “Drug-induced liver injury (DILI) is an important cause of hepatic disease being estimated to account for approximately 5% of cases of jaundice and 10% of cases of acute hepatitis admitted to hospitals. Antibiotics are an often underreported cause of hepatotoxicity occurring in about 1 of 10,000 individuals.”

There have been a handful of Zithromax liver damage cases, which the authors used as a foundation for their research.

“In these patients, liver biopsy showed intrahepatic cholestasis and periportal necroinflammatory infiltrate with lymphocytes and eosinophils and liver injury rapidly resolved with discontinuation of the medication. We here report the case of a prolonged cholestatic hepatitis after administration of azithromycin in a young woman with no history of liver disease.”

Known only as “Mary,” the 26-year-old woman was admitted to the author’s hospital in Italy. The hospital is a third-level center for the diagnosis and treatment of liver disease. Mary was admitted in late 2010 due to two months of battling jaundice, a red flag for liver disease.

“Her medical history included allergic asthma requiring seasonal cycles with inhaled corticosteroids and antihistaminics, intolerance to cephalosporins, and penicillins, ovarian cysts treated with ethinyl estradiol and cholecystectomy during infancy due to symptomatic biliary gallstones. She denied smoking, alcohol or herbal medicine consumption, illicit drugs use, or exposure to any toxic agent. Finally, she had no history of preexisting liver, cardiac, or renal disease,” the report states.

In May of that year, Mary was prescribed Zithromax for an upper respiratory tract infection. On the third day, she reportedly  had a skin rash and pink eye, which was quickly treated. Two days later, jaundice appeared. Mary was admitted to a community hospital, but continued to experience what may have been Zithromax side effects. A number of routine tests came back negative. The jaundice was treated, but doctors couldn’t find the root of the issue.

“She was then discharged at the end of May without improvement of liver tests, which remained steadily elevated during the following month,” the authors wrote. “The patient was therefore admitted to our hospital for a reevaluation of the liver disease. At admission, the patient was jaundiced and presented hitching with multiple scratch marks over the entire body, particularly at the lower limbs. No other stigmata of chronic liver disease and liver failure were found.”

Mary underwent several more tests until a positive one appeared. “The immunological exploration revealed a positive antinuclear antibody (ANA) with a speckled pattern and positive anti-SS-A and SS-B antibodies. … Subsequently, she had a liver biopsy that revealed a picture of cholestatic hepatitis with a severe reduction of the native biliary ducts. … According to the clinical scale for the diagnosis of DILI developed and validated by Maria and Victorino, we confirmed the initial diagnosis of azithromycin-induced liver injury.”

Identifying Zithromax Liver Damage

According to the doctors, “Taking into account the absence of extrahepatic manifestation, except for the initial transient skin rash, and of a positive rechallenge test, our patient reached a total score of 15 corresponding to a ‘probable’ diagnosis of DILI. However, an important information came up from a more accurate anamnesis: an episode of transient dark urine and hypocholic stools following a 3-day treatment with azithromycin, given for an upper respiratory tract infection, occurred few months before. Thus, if this episode represented the first exposure to the drug, the actual jaundice could be considered the positive rechallenge test. As a result, the patient reached 18 as total score corresponding to a ‘definite’ diagnosis of DILI.”

Zithromax hazards can vary greatly, but may include liver damage.

“Symptoms, usually represented by jaundice and hitching, developed few days (from 3 to 10) after the beginning of azithromycin therapy, and their resolution occurred within a maximum of two months (from 4 to 60 days) after antibiotic withdrawal.” However, the authors warn, “DILI is typically idiosyncratic and is usually unpredictable until the drug is given.”

Additionally, “DILI is often misdiagnosed since a correct medication history showing a temporal relationship between drug administration and onset of liver injury is frequently difficult to ascertain. Furthermore, drugs can mimic almost every naturally occurring liver disease affecting man, and, finally, all the other potential causes of liver disease need to be ruled out.”

Were You Diagnosed with Liver Damage After Taking Z-Pak?

A growing Zithromax class action lawsuit include victims who were diagnosed with liver damage after taking the drug. If this happened to you, you might qualify for a Zithromax legal claim. Read more at the Zithromax Lawsuit: Z-Pak Zithromax Azithromycin Heart Attack Class Action Lawsuit Settlement Investigation today. Once you submit your information, an attorney will contact you if you have a case for a free Zithromax claim review.