Intrahepatic Cholestasis Due to Therapy of Rheumatoid Arthritis

Two patients are reported who developed hepatic disease with predominant intrahepatic cholestasis as a result of therapy directed at rheumatoid arthritis. In the 1st patient, the obstructive jaundice could reasonably be ascribed to gold therapy alone, whereas in the second individual either gold or phenylbutazone were implicated. Both patients had protracted and severe hepatic dysfunction. This rare reaction to these agents must be considered in the differential diagnosis of obstructive jaundice in patients with rheumatoid arthritis receiving this therapy.