Annals of internal medicine · 2002
Mixed hepatocellular-cholestatic liver injury after pioglitazone therapy.
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May Louis D, Lefkowitch Jay H, Kram Michael T, Rubin David E
Аннотация
BACKGROUND: Pioglitazone is an oral hypoglycemic agent in the thiazolidinedione class. Only one case of hepatotoxicity related to this agent has previously been reported.
OBJECTIVE: To report the clinical course of a patient with hepatitis after therapy with pioglitazone.
DESIGN: Case report.
SETTING: A community hospital.
PATIENT: A 49-year-old diabetic man taking pioglitazone, 30 mg/d.
INTERVENTION: Discontinuation of pioglitazone therapy.
MEASUREMENTS: Serum aminotransferase and bilirubin levels, standard blood tests for causes of hepatitis and cirrhosis other than drug toxicity, and liver biopsy.
RESULTS: After 6 months of pioglitazone therapy, significant hepatic dysfunction developed. Blood tests excluded viral, metabolic, and autoimmune disorders. Liver biopsy showed mixed hepatocellular-cholestatic injury compatible with drug toxicity. After treatment with pioglitazone was discontinued, liver enzyme values returned to normal.
CONCLUSION: Patients receiving pioglitazone may develop serious liver injury and should be observed for evidence of hepatitis.
OBJECTIVE: To report the clinical course of a patient with hepatitis after therapy with pioglitazone.
DESIGN: Case report.
SETTING: A community hospital.
PATIENT: A 49-year-old diabetic man taking pioglitazone, 30 mg/d.
INTERVENTION: Discontinuation of pioglitazone therapy.
MEASUREMENTS: Serum aminotransferase and bilirubin levels, standard blood tests for causes of hepatitis and cirrhosis other than drug toxicity, and liver biopsy.
RESULTS: After 6 months of pioglitazone therapy, significant hepatic dysfunction developed. Blood tests excluded viral, metabolic, and autoimmune disorders. Liver biopsy showed mixed hepatocellular-cholestatic injury compatible with drug toxicity. After treatment with pioglitazone was discontinued, liver enzyme values returned to normal.
CONCLUSION: Patients receiving pioglitazone may develop serious liver injury and should be observed for evidence of hepatitis.