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Puzzling JaundiceProbable Relationship to Laxative Ingestion
Telfer B. Reynolds, MD;
Allen C. Lapin, MD;
Robert L. Peters, MD;
Harry S. Yamahiro, MD
JAMA. 1970;211(1):86-90.
Abstract
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Four women, ages 47 to 86 years, had a similar, moderately severe illness characterized by fatigue, vague abdominal symptoms, jaundice, and moderate hepatomegaly. Laboratory abnormalities consisted of hyperbilirubinemia, moderate to marked increase in transaminase activity (peak serum glutamic pyruvic transaminase level, 640 to 2,160 Karmen units/ml), and moderate alkaline phosphatase level increase. Liver biopsy in two patients showed portal lymphoid proliferation and evidence of moderate hepatocellular necrosis. All patients had been taking a laxative containing dioctyl sodium sulfosuccinate, carboxymethylcellulose sodium, and oxyphenisatin acetate (Dialose Plus). Two of the ingredients contained in Dialose Plus (dioctyl sodium sulfosuccinate and carboxymethylcellulose sodium) are nonabsorbable while the other ingredient (oxyphenisatin acetate) is a propellant which is excreted in the bile and is presumed to be the cause of the hepatic reaction. Jaundice subsided when Dialose Plus therapy was stopped and recurred in two patients when it was restarted. The other two patients under observation in the hospital were challenged with Dialose Plus with positive results.
Author Affiliations
From the departments of medicine (Drs. Reynolds, Lapin, and Yamahiro) and pathology (Dr. Peters) of the School of Medicine of the University of Southern California, Los Angeles.
Footnotes
Presented at the 70th meeting of the American Gastroenterological Association, Washington, DC, May 16, 1969.
Reprints are not available.
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ABSTRACT
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