Case Reports
Thiabendazole-induced acute liver failure requiring transplantation and subsequent diagnosis of polyarteritis nodosa
M. Groh, P. Blanche, Y. Calmus, L. Guillevin
CER5436
2012 Vol.30, N°1 ,Suppl.70
PI 0107, PF 0109
Case Reports
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PMID: 22640653 [PubMed]
Received: 01/02/2012
Accepted : 28/02/2012
In Press: 11/05/2012
Published: 11/05/2012
Abstract
Polyarteritis nodosa (PAN), a systemic necrotising vasculitis that affects medium- and small-sized arteries, has visceral involvement in 40–60% of the patients. According to the Five-Factor Score (FFS), it is associated with poor outcome. We describe a patient who underwent orthotopic liver transplantation (OLT) for severe ductopenia induced by thiabendazole that was empirically prescribed for chronic hypereosinophilia. Eleven years later, despite immunosuppressive treatment to prevent graft rejection, he developed mononeuritis multiplex; PAN was diagnosed. He also had severe recurrent ischaemic cholangitides because of post-OLT hepatic artery ligation to treat a postoperative severe haematemesis. His outcome was favourable after second OLT, under steroids, cyclophosphamide pulses and tacrolimus. In retrospect, his initial symptoms and hypereosinophilia were probably attributable to PAN.