BMJ Case Reports 2009; doi:10.1136/bcr.09.2008.0950
  • Unexpected outcome (positive or negative) including adverse drug reactions

Metformin-induced cholangiohepatitis

  1. Raja Shekhar Reddy Sappati Biyyani1,
  2. Smitha Battula2,
  3. Christopher A Erhardt3,
  4. Khalil Korkor2,3,4
  1. 1
    Case Western Reserve University @ MetroHealth Medical Center, Hospital Medicine, 2500 MetroHealth Dr, Cleveland, Ohio, 44138, USA
  2. 2
    Gastroenterology of Canton Inc, 4124 Munson Rd NW, Canton, Ohio, 44718, USA
  3. 3
    Mercy Medical Center, 1320 Mercy Dr NW, Canton, Ohio, 44708, USA
  4. 4
    NEOUCOM, Gastroenterology, Gastroenterology of Canton Inc, 4124 Munson St NW, Canton, Ohio, 44718, USA
  1. Raja Shekhar Reddy Sappati Biyyani, rsappati{at}
  • Published 14 July 2009


Drug-induced cholangiohepatitis accounts for 20–50% of non-viral chronic hepatitis cases. Metformin is the most commonly prescribed oral anti-diabetic drug from the biguanide class used in treatment of overweight and obese type 2 diabetes mellitus patients. Metformin-induced cholangiohepatitis with marked elevations in serum liver transaminases and intrahepatic cholestasis has been infrequently reported. Here, we report a case of acute cholangiohepatitis after initiation of metformin treatment.


  • Competing interests: none.

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