A case of ceftriaxone-induced biliary pseudolithiasis with severe motor and intellectual disabilities.

Abstract

Herein, we describe a patient with severe motor and intellectual disabilities (SMID) having ceftriaxone-induced biliary pseudolithiasis. In the gallbladder, ceftriaxone is known to induce the production of precipitates that mimic a gallstone on sonograms. The term “pseudolithiasis” is used to denote a reversible condition that takes several days to disappear. Ceftriaxone-associated pseudolithiasis is a benign condition usually without clinical signs. However, we report a patient with SMID who showed gallstone attack-like symptoms and pseudolithiasis that lasted for 4 months after the last administration of ceftriaxone. To our knowledge, no previous report has described a patient with SMID having ceftriaxone-induced pseudolithiasis. In the present patient, the insufficient secretion of gastrointestinal hormones and impaired sensitivity of the gallbladder to gastrointestinal hormones and neuronal systems probably caused the failure of gallbladder contractions. Although pseudolithiasis rarely causes clinical symptoms, the administration of ceftriaxone should be carefully monitored in patients with SMID.