Short communication, Note
Acute Oxcarbazepine-Induced Hepatotoxicity in a Patient Susceptible to Developing Drug-Induced Liver Injury
Miljenka Planjar-Prvan
; University of Zagreb, »Sveti Duh« University Hospital, University Department of Neurology, Zagreb, Croatia
Ana Bielen
; University of Zagreb, Faculty of Food Technology and Biotechnology, Laboratory for Biology and Microbial Genetics, Zagreb, Croatia
Ana Sruk
; University of Zagreb, »Sveti Duh« University Hospital, University Department of Neurology, Zagreb, Croatia
Marinko Marusic
; University of Zagreb, »Sveti Duh« University Hospital, Department of Hepatogastroenterology, Zagreb, Croatia
Ivan Bielen
; University of Zagreb, »Sveti Duh« University Hospital, University Department of Neurology, Zagreb, Croatia
Abstract
Oxcarbazepine (OXC) is generally accepted as a drug without risk of severe drug-induced hepatotoxicity, but according to recently reported pharmacovigilance data this statement has been challenged. However, in the literature there have been no reports of acute OXC-induced hepatotoxicity without systemic manifestations of Drug Rash with Eosinophilia and Systemic Symptoms (DRESS) syndrome. We present a female with seizures one month after delivery who had borderline
elevated liver enzymes prior to the initiation of OXC treatment. Two weeks after introducing OXC, highly elevated liver enzymes were found. After discontinuation of OXC the enzymes continued to rise for another week, and afterward gradually decreased. The causal relationship with OXC intake was determined to be highly probable. Two years later, the transitory elevation of liver enzymes was observed during the treatment of acute tonsilopharingitis with amoxicillin + clavulanic acid. The repeated elevation of liver enzymes related to use of different drugs might indicate patient`s susceptibility for drug induced liver injuries.We suggest that monitoring of liver function tests would be clinically rational for early detection of acute OXC-induced liver hepatotoxicity in the patients with clinical and/or laboratory features which might be interpreted as possible risk factors of the increased susceptibility to drug induced liver injuries.
Keywords
oxcarbazepine; hepatotoxicity; reactive metabolite; 9-acridan; idiosyncratic reaction
Hrčak ID:
99602
URI
Publication date:
3.4.2013.
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