{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,4]],"date-time":"2026-02-04T15:24:17Z","timestamp":1770218657490,"version":"3.49.0"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","license":[{"start":{"date-parts":[[2015,9,1]],"date-time":"2015-09-01T00:00:00Z","timestamp":1441065600000},"content-version":"tdm","delay-in-days":9162,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[1990,8]]},"abstract":"<jats:sec>\n            <jats:title\/>\n            <jats:p>Although liver injury after administration of the trimethoprim\u2013sulfamethoxazole combination is rare, hepatocellular necrosis and cholestasis have developed in a few cases. We describe a patient who developed a severe, prolonged cholestatic reaction after trimethoprim\u2013sulfamethoxazole administration. The findings from serial liver biopsy samples showed characteristic abnormalities of phospholipidosis that have not been previously described for trimethoprimsulfamethoxazole-related hepatic injury. The most prominent finding on electron microscopic evaluation of the liver was the presence of prominent hepatocyte lysosomal inclusions characterized by concentric arrangements of membranous and lamellated structures. The patient improved after several courses of exchange plasmapheresis, which may have assisted in the removal of toxic drug\u2013lipid complexes. The pathogenesis of this acquired secondary phospholipidosis is unknown. Possible mechanisms include generation of highly lipid\u2013soluble metabolites and inhibition of the lysosomal enzyme phospholipase A<jats:sub>1<\/jats:sub>. (Hepatology 1990; 12:342-347).<\/jats:p>\n          <\/jats:sec>","DOI":"10.1002\/hep.1840120223","type":"journal-article","created":{"date-parts":[[2007,3,3]],"date-time":"2007-03-03T23:35:38Z","timestamp":1172964938000},"page":"342-347","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":51,"title":["Intrahepatic Cholestasis and Phospholipidosis Associated With the Use of Trimethoprim\u2013Sulfamethoxazole"],"prefix":"10.1097","volume":"12","author":[{"given":"Santiago J.","family":"Mu\u00f1oz","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Antonino","family":"Martinez-Hernandez","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Willis C.","family":"Maddrey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"10.1002\/hep.1840120223-BIB1","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1093\/infdis\/128.Supplement_3.S657","volume":"128","author":"Brumfitt","year":"1973","journal-title":"J Infect Dis"},{"key":"10.1002\/hep.1840120223-BIB2","doi-asserted-by":"crossref","first-page":"762","DOI":"10.7326\/0003-4819-92-6-762","volume":"92","author":"Winston","year":"1980","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.1840120223-BIB3","doi-asserted-by":"crossref","first-page":"633","DOI":"10.1002\/j.1552-4604.1986.tb02963.x","volume":"26","author":"Beard","year":"1986","journal-title":"J Clin Pharmacol"},{"key":"10.1002\/hep.1840120223-BIB4","doi-asserted-by":"crossref","first-page":"205","DOI":"10.3109\/00365528209182041","volume":"17","author":"Dossing","year":"1982","journal-title":"Scand J Gastroenterol"},{"key":"10.1002\/hep.1840120223-BIB5","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1093\/clinids\/4.2.429","volume":"4","author":"Lawson","year":"1982","journal-title":"Rev Infect Dis"},{"key":"10.1002\/hep.1840120223-BIB6","doi-asserted-by":"crossref","first-page":"952","DOI":"10.1001\/jama.1975.03260090018007","volume":"233","author":"Colucci","year":"1975","journal-title":"JAMA"},{"key":"10.1002\/hep.1840120223-BIB7","first-page":"199","volume":"31","author":"Horak","year":"1984","journal-title":"Hepatogastroenterology"},{"key":"10.1002\/hep.1840120223-BIB8","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1016\/0016-5085(81)90146-3","volume":"80","author":"Ransohoff","year":"1981","journal-title":"Gastroenterology"},{"key":"10.1002\/hep.1840120223-BIB9","doi-asserted-by":"crossref","first-page":"1691","DOI":"10.1001\/archinte.144.8.1691","volume":"144","author":"Thies","year":"1984","journal-title":"Arch Intern Med"},{"key":"10.1002\/hep.1840120223-BIB10","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1093\/milmed\/149.2.80","volume":"149","author":"Kossow","year":"1984","journal-title":"Milit Med"},{"key":"10.1002\/hep.1840120223-BIB11","doi-asserted-by":"crossref","first-page":"511","DOI":"10.7326\/0003-4819-92-4-511_2","volume":"92","author":"Nair","year":"1980","journal-title":"Ann Intern Med"},{"key":"10.1002\/hep.1840120223-BIB12","first-page":"356","volume":"76","author":"Abi-Mansur","year":"1981","journal-title":"Am J Gastroenterol"},{"key":"10.1002\/hep.1840120223-BIB13","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1177\/000992288302200310","volume":"22","author":"Ghishan","year":"1983","journal-title":"Clin Pediatr"},{"key":"10.1002\/hep.1840120223-BIB14","doi-asserted-by":"crossref","first-page":"1072","DOI":"10.1136\/bmj.293.6554.1072-a","volume":"293","author":"Tanner","year":"1986","journal-title":"Br Med J"},{"key":"10.1002\/hep.1840120223-BIB15","doi-asserted-by":"crossref","first-page":"897","DOI":"10.1097\/00007611-198107000-00035","volume":"74","author":"Coto","year":"1981","journal-title":"South Med J"},{"key":"10.1002\/hep.1840120223-BIB16","first-page":"169","volume":"68","author":"Acero","year":"1985","journal-title":"Rev Esp Enfern Apar Dig"},{"key":"10.1002\/hep.1840120223-BIB17","doi-asserted-by":"crossref","first-page":"202","DOI":"10.1136\/pgmj.56.653.202","volume":"56","author":"Ogilvie","year":"1980","journal-title":"Postgrad Med J"},{"key":"10.1002\/hep.1840120223-BIB18","first-page":"360","volume":"4","author":"Acero","year":"1981","journal-title":"Gastroenterol Hepatol"},{"key":"10.1002\/hep.1840120223-BIB19","first-page":"192","volume-title":"The liver","author":"Phillips","year":"1987","unstructured":", , , eds. 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