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We performed a retrospective review of hospital records of patients with cholestatic jaundice, referred to the Paediatric Surgical Unit of Tygerberg Hospital from 2001 to 2011 (Table 1).
Hyperthyroidism is reported to be associated with deterioration of liver function tests as either elevated transaminase levels (1) or findings suggestive of cholestatic jaundice (1,2).
A 35-year-old woman presented with cholestatic jaundice and partial bowel obstruction following 3 months' history of intermittent abdominal pain, nausea and vomiting.
Patients with liver involvement are often asymptomatic, but where symptoms do occur they may present with vague abdominal pain, a secondary liver abscess, cholestatic jaundice or cyst rupture with or without anaphylaxis.
Ultrasound and computed tomographic imaging failed to reveal any hepatic ductal dilation, and her elevated liver enzymes and bilirubin were consistent with a cholestatic jaundice.
Serious adverse events at least possibly related to treatment included one case of pancreatitis at the 300 mg/m2/day dose level; and at the over 300 mg/m2/day dose level, there were two cases of pancreatitis and one case each of diarrhea, cholestatic jaundice and dehydration.