A Case of Cholestasis: Benign and Recurrent and Not due to Measles

Abstract

To the Editor.— In 1983 we reported in JAMA the case of a 19-year-old man who had a well-documented measles infection and cholestasis. 1 Jaundice appeared a few days after clinical symptoms of rubella. His total bilirubin level increased to 740 μmol/L, while his serum γ-glutamyltransferase level was normal. Endoscopic retrograde cholangiography showed normal biliary ducts. The usual causes of intrahepatic cholestasis were excluded. Histological study of the liver showed major centrolobular cholestasis without necrosis. Jaundice continued for 4 months, but 5 months after the onset results of liver function tests were normal. Rubella seemed to have been the most likely explanation for the cholestasis. This case had a few points in common with that reported by McLellan and Gleiner. 2 Our patient remained in good condition until September 3, 1988, when he developed a pharyngitis. He received 1500 mg/d of troleandomycin. Two days later, troleandomycin therapy was discontinued because