Cholestatic Jaundice in Patients Treated with Erythromycin Estolate

Cholestatic jaundice occurred in 4 patients who had been treated for variable periods with erythromycin estolate (Ilosone). All of these patients had a history of strong allergies, and the onset of disease was accompanied by itching, anorexia, and nausea, followed by jaundice. Eosinophilia was found in 3 of them. Epigastric distress was common and occasionally severe. The duration of jaundice ranged from 2 weeks to more than 15 weeks, and although complete recovery occurred in 3 patients, 1 still had evidence of hepatic dysfunction with hepatomegaly 6 months after the onset of disease. While it is impossible to prove that they did not have viral hepatitis, the history of multiple allergies, the eosinophilia, and the biochemical alterations in the blood suggest a drug-induced hepatitis due to hypersensitivity.