Cholestatic Jaundice Following Chlorpropamide Self-Poisoning

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Abstract
A nondiabetic patient is described who survived a massive overdose of chlorpropamide and developed cholestatic jaundice as a delayed complication. Recovery of this patient was largely attributable to the short interval between chlorpropamide ingestion and the start of treatment, which involved i.v. glucose infusion. Plasma insulin levels are discussed. Histologic evidence of hepatocellular injury was not present, and the absence of a rash or eosinophilia suggests a non-hypersensitivity mechanism. Cholestasis was a late complication, with a latent interval between stimulus and icterus of 14 days, and it appeared when chlorpropamide was no longer detectable in the patient''s serum. The mechanism is presumably similar to chlorpropamide-induced cholestasis in diabetes.