Development of biliary and renal stone and sludge after taking Ceftriaxone is associated with a defect in UDP‐Glucuronosyltransferase (ie Gilbert’s syndrome)

Abstract

Background In addition to patient concerns, drug side effects increase health care costs. Although the Ceftriaxone biliary or renal stone and sludge some time is asymptomatic and self‐healing, but some of them are dangerous and may lead to hospitalisation or surgical intervention. Aims Examine the relation between biliary or renal stone and sludge due to ceftriaxone in patients with different variants of UGT1A1 gene. Methods In this cohort study, 176 unrelated infants and children under 12 years of age who receive ceftriaxone were enrolled the study. Each patient before, along treatment and 2 weeks after discharging, follows up with gallbladder and kidneys ultrasonography. Standard blood samples were taken for biochemical and genetic tests. The promoter and exon 1 regions of UGT1A1 gene were sequenced by using Sanger method. All the collected data were analysed by Chi‐squared, one‐way ANOVA, Kruskal‐Wallis, and Mann‐Whitney tests through SPSS Software (version 21). Results Eighty participants (45.5%) were female and the remaining (n = 96; 54.5%) were male. The results showed that 16.5% of participants had abnormal gallbladder conditions. The results suggested that in patients with TA7/7, and Gly71Arg (G/A) genotype (ie Gilbert's syndrome) the prevalence of biliary sludge and stone was significantly higher than the control group (P = 0.008 and 0.05 respectively).

Commentary: Profiling of UGT1A1*6, UGT1A1*60, UGT1A1*93, and UGT1A1*28 Polymorphisms in Indonesian Neonates With Hyperbilirubinemia Using Multiplex PCR Sequencing

“…In this study, four polymorphisms in the UGT1A1 gene were investigated. By paying attention to the location of the single nucleotide polymorphisms, at least two genes UGT1A1 * 60(−3279T>G) and UGT1A1 * 6(−3156G>A) are situated in very close proximity (4).…”