Laxative-Induced Chronic Liver Disease

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Abstract
Chronic liver disease is described in 5 patients who had used oxyphenisatin laxative for more than 6 months. Active chronic hepatitis was diagnosed in 3 and cryptogenetic cirrhosis in 2. Four had been treated with Prednisone and one with additional Azathioprine. Symptoms were fatigue, varying degree of jaundice, and hepatomegaly in all, oesophageal varices in two, and ascites in one. Serum bilirubin, transaminases, and gamma-globulins were increased in all, and albumin and Normotest low in four. LE-factor test was positive in one, ANF in two, SMA in one, MA in one, and three had elevated serum IgA. Liver histology was compatible with aggressive hepatitis in three and cirrhosis in two. Challenges with oxyphenisatin caused abrupt rise in serum OCT, SGOT, and SGPT. A fall was observed after withdrawal. Clinical, histological, and biochemical improvement occurred when the oxyphenisatin laxative was stopped.

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