scholarly journals Rifampicin for Treatment of Cholestatic Pruritus Caused by Drug-Induced Acute Liver Injury as Assessed by the RUCAM Classification

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ali R. Ahmadi ◽  
Maria Chicco ◽  
Marcel van den Berge
Keyword(s):  
Risk Factors ◽  
Liver Injury ◽  
Laboratory Testing ◽  
Acute Liver Injury ◽  
Anabolic Steroids ◽  
Black Market ◽  
Radiographic Imaging ◽  
Drug Induced ◽  
Liver And Kidney ◽  
History Of

A male bodybuilder of 39 years of age developed severe pruritus, nausea, and jaundice after injecting anabolic steroids purchased on the black market. The patient had no history of liver disease and no risk factors for viral hepatitis. Extensive laboratory testing, radiographic imaging, and liver biopsy excluded a majority of potential pathologies. The patient was diagnosed with drug-induced acute liver injury and secondary acute renal failure most likely caused by testosterone purchased on the black market. The pruritus caused insomnia and significant psychological distress. Treatment was initiated with cholestyramine and naltrexone for one week with no effect on the pruritus. Subsequently, all medications were stopped, and rifampicin was started. Pruritus resolved after starting rifampicin, and liver and kidney function improved rapidly and normalized within 5 months.

scholarly journals Bicalutamide-Associated Acute Liver Injury and Migratory Arthralgia: A Rare but Clinically Important Adverse Effect

2018 ◽  
Vol 12 (2) ◽  
pp. 266-270 ◽  
Author(s):  
Helga M. Gretarsdottir ◽  
Elin Bjornsdottir ◽  
Einar S. Bjornsson
Keyword(s):  
Prostate Cancer ◽  
Liver Injury ◽  
Causality Assessment ◽  
Acute Liver Injury ◽  
Assessment Method ◽  
Hepatitis Viruses ◽  
Drug Induced ◽  
History Of ◽  
Upper Abdomen ◽  
Liver Tests

We describe a case of acute liver injury and migratory arthralgia in a patient receiving bicalutamide treatment for prostate cancer. A 67-year-old male with metastatic prostate cancer presented with a 6-day history of migratory arthralgia. He had been undergoing treatment with bicalutamide for 4 months; 3 weeks prior to symptom appearance the bicalutamide dose had been increased. He had no other symptoms. Liver tests and inflammatory markers were markedly elevated. Serology for hepatitis viruses A, B, and C, CMV, and EBV and autoimmune causes were all negative, and an ultrasound of the upper abdomen was normal. There was no history of blood transfusion, intravenous drug abuse, or alcohol abuse. Due to the suspicion of a drug-induced symptomatology, bicalutamide was discontinued and the patient started on 30 mg prednisolone daily. Three weeks later he was symptom free and after 6 weeks his liver tests were almost normal. The Roussel Uclaf Causality Assessment Method (RUCAM) suggested a high probability of liver injury. Bicalutamide has very rarely been reported as a causative agent for liver injury and to our knowledge never for migratory polyarthralgia. The migratory polyarthralgia was attributed to bicalutamide due to the absence of other etiological factors and the disappearance of symptoms after discontinuation of the drug. To our knowledge, this is the first published case report of migratory arthralgia and concomitant liver injury attributed to bicalutamide.

scholarly journals Diphenhydramine as a Cause of Drug-Induced Liver Injury

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Yunseok Namn ◽  
Yecheskel Schneider ◽  
Isabelle H. Cui ◽  
Arun Jesudian
Keyword(s):  
Liver Injury ◽  
Acute Liver Injury ◽  
Chromosomal Translocation ◽  
Altered Mental Status ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Patient Reported ◽  
History Of ◽  
Concomitant Medications ◽  
Unites States

Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the Unites States and accounts for 10% of acute hepatitis cases. We report the only known case of diphenhydramine-induced acute liver injury in the absence of concomitant medications. A 28-year-old man with history of 13/14-chromosomal translocation presented with fevers, vomiting, and jaundice. Aspartate-aminotransferase and alanine-aminotransferase levels peaked above 20,000 IU/L and 5,000 IU/L, respectively. He developed coagulopathy but without altered mental status. Patient reported taking up to 400 mg diphenhydramine nightly, without concomitant acetaminophen, for insomnia. He denied taking other medications, supplements, antibiotics, and herbals. A thorough workup of liver injury ruled out viral hepatitis (including A, B, C, and E), autoimmune, toxic, ischemic, and metabolic etiologies including Wilson’s disease. A liver biopsy was consistent with DILI without evidence of iron or copper deposition. Diphenhydramine was determined to be the likely culprit. This is the first reported case of diphenhydramine-induced liver injury without concomitant use of acetaminophen.

scholarly journals Albendazole-induced liver injury of a 11-year-old girl

2019 ◽  
pp. 83-88
Author(s):  
S. N. Borzakova ◽  
L. A. Kharitonova ◽  
M. N. Ermakova ◽  
I. M. Osmanov ◽  
E. V. Rudikova
Keyword(s):  
Risk Factors ◽  
Liver Injury ◽  
Fat Metabolism ◽  
Female Gender ◽  
The Self ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Antiparasitic Drug ◽  
Pathogenetic Therapy ◽  
History Of

A case of the drug-induced liver injury (DILI) development is presented on the background of the self-treatment with an antiparasitic drug Albendazole in an 11 years-old girl with several risk factors for the drug-induced liver injury (history of a drug reaction, carbohydrate and fat metabolism disturbance, female gender, and adolescence). The disease was diagnosed using the the CIOMS/RUCAM scale. The drug was withdrawn and the pathogenetic therapy was established (fluids, hepatoprotective drugs) with the resolution of the drug-induced hepatitis.

scholarly journals Genetic Risk Factors in Drug‐Induced Liver Injury Due to Isoniazid‐Containing Antituberculosis Drug Regimens

2020 ◽  
Author(s):  
Paola Nicoletti ◽  
Harshad Devarbhavi ◽  
Ashish Goel ◽  
Radha Venkatesan ◽  
Chundamannil E. Eapen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Liver Injury ◽  
Genetic Risk ◽  
Genetic Risk Factors ◽  
Antituberculosis Drug ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Drug Regimens

scholarly journals Acetaminophen Test Battery (ATB): A Comprehensive Method to Study Acetaminophen-Induced Acute Liver Injury

2020 ◽  
Vol 20 (2) ◽  
pp. 125-138 ◽  
Author(s):  
Bharat Bhushan ◽  
Udayan Apte
Keyword(s):  
Liver Injury ◽  
Acute Liver Injury ◽  
Test Battery ◽  
Western World ◽  
Drug Induced ◽  
Technical Problems ◽  
Drug Induced Liver Injury ◽  
Comprehensive Method ◽  
Injury Models ◽  
Apap Hepatotoxicity

Acetaminophen (APAP) overdose is the major cause of acute liver failure (ALF) in the Western world. Extensive research is ongoing to identify the mechanisms of APAP-induced ALF. APAP-induced acute liver injury is also one of the most commonly studied drug-induced liver injury models in the field of hepatotoxicity. APAP toxicity is triphasic and includes three mechanistically interlinked but temporally distinct phases of initiation, progression, and recovery/regeneration. Despite how commonly it is studied, the methods to study APAP toxicity differ significantly, often leading to confusing and contradictory data. There are number of reviews on mechanisms of APAP toxicity, but a detailed mechanism-based comprehensive method and list of assays that covers all phases of APAP hepatotoxicity are missing. The goal of this review is to provide a standard protocol and guidelines to study APAP toxicity in mice including a test battery that can help investigators to comprehensively analyze APAP toxicity in the specific context of their hypothesis. Further, we will identify the major roadblocks and common technical problems that can significantly affect the results. This acetaminophen test battery (ATB) will be an excellent guide for scientists studying this most common and clinically relevant drug-induced liver injury and will also be helpful as a roadmap for hypothesis development to study novel mechanisms.

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