Lucena González, María IsabelAndrade Bellido, Raul JesúsVicioso Recio, LuisGonzález, F JesúsPachkoria, KetevanGarcía-Muñoz, Beatriz2013-03-122013-03-122006-08-28Lucena González MI, Andrade Bellido RJ, Vicioso Recio L, González FJ, Pachkoria K, García-Muñoz B. Prolonged cholestasis after raloxifene and fenofibrate interaction: A case report. World J. Gastroenterol. 2006; 12(32):5244-61007-9327 (Printhttp://hdl.handle.net/10668/822Case Reports; Journal Article; Research Support, Non-U.S. Gov't;Assigning causality in drug-induced liver injury is challenging particularly when more than one drug could be responsible. We report a woman on long-term therapy with raloxifen who developed acute cholestasis shortly after starting fenofibrate. The picture evolved into chronic cholestasis. We hypothesized that an interaction at the metabolic level could have triggered the presentation of hepatotoxicity after a very short time of exposure to fenofibrate in this patient. The findings of an overexpression of vascular endothelial growth factor in the liver biopsy suggest that angiogenesis might play a role in the persistence of toxic cholestasis.enDrug-drug InteractionsHepatotoxicityCausality AssessmentColestasisFenofibratoHígadoHipolipemiantesRaloxifenoBiopsiaModuladores Selectivos de los Receptores de EstrógenoMediana edadHumanosFemeninoMedical Subject Headings::Diseases::Digestive System Diseases::Biliary Tract Diseases::Bile Duct Diseases::CholestasisMedical Subject Headings::Check Tags::FemaleMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Carboxylic Acids::Acids, Acyclic::Butyrates::Isobutyrates::Fibric Acids::FenofibrateMedical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::HumansMedical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Molecular Mechanisms of Pharmacological Action::Antimetabolites::Hypolipidemic AgentsMedical Subject Headings::Anatomy::Digestive System::LiverMedical Subject Headings::Named Groups::Persons::Age Groups::Adult::Middle AgedMedical Subject Headings::Chemicals and Drugs::Organic Chemicals::Hydrocarbons::Hydrocarbons, Cyclic::Hydrocarbons, Aromatic::Benzene Derivatives::Benzylidene Compounds::Stilbenes::Tamoxifen::RaloxifeneMedical Subject Headings::Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormone Antagonists::Estrogen Receptor Modulators::Selective Estrogen Receptor ModulatorsMedical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Surgical Procedures, Operative::Biopsyresearch article16937543open access2219-2840