Chlorpromazine-induced vanishing bile duct syndrome leading to biliary cirrhosis

Hepatology. 1994 Dec;20(6):1437-41. doi: 10.1002/hep.1840200610.


We describe a 33-yr-old pregnant woman in whom a primary biliary cirrhosis-like syndrome developed after 2 wk of chlorpromazine therapy. The clinical course was characterized by severe jaundice lasting 22 mo, intense pruritus, fever, steatorrhea, high alkaline phosphatase levels and hypercholesterolemia. Jaundice resolved with initiation of ursodeoxycholic acid therapy, but subclinical cholestasis and low-level inflammatory activity persisted and ultimately evolved into biliary cirrhosis. The pathological substrate of this severe and prolonged cholestatic reaction was found to be the vanishing bile duct syndrome with a marked transient pseudoxanthomatosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Bile Ducts / drug effects*
  • Bile Ducts / pathology
  • Biopsy
  • Chlorpromazine / adverse effects*
  • Cholestasis / chemically induced*
  • Cholestasis / complications
  • Cholestasis / pathology
  • Female
  • Humans
  • Liver / pathology
  • Liver Cirrhosis, Biliary / etiology*
  • Liver Cirrhosis, Biliary / pathology
  • Pregnancy
  • Pregnancy Complications*
  • Syndrome


  • Chlorpromazine