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- Title
Severe liver injury after treatment with the leukotriene receptor antagonist zafirlukast.
- Authors
Reinus, John F.; Persky, Seth; Burkiewicz, Jill S.; Quan, David; Bass, Nathan M.; Davern, Timothy J.; Reinus, J F; Persky, S; Burkiewicz, J S; Quan, D; Bass, N M; Davern, T J
- Abstract
<bold>Background: </bold>In registration trials, zafirlukast, an asthma medication, caused asymptomatic elevated aminotransferase levels in up to 5% of participants. Until now, however, no cases of severe hepatitis attributed to zafirlukast have been reported.<bold>Objective: </bold>To report the clinical characteristics of three patients with severe hepatitis due to zafirlukast.<bold>Design: </bold>Case report.<bold>Setting: </bold>One community hospital and two university hospitals.<bold>Patients: </bold>Three middle-aged women taking zafirlukast, 20 mg twice per day.<bold>Intervention: </bold>Discontinuation of zafirlukast therapy in three patients, steroid therapy in two patients, and orthotopic liver transplantation in one patient.<bold>Measurements: </bold>Serum aminotransferase and bilirubin levels, standard blood tests for causes of hepatitis other than drug toxicity, and liver biopsy in two patients.<bold>Results: </bold>Patient 1 recovered spontaneously, had a severe relapse after inadvertent rechallenge with the medication, and ultimately made a complete recovery. Patient 2 developed subfulminant hepatic failure and required liver transplantation. Patient 3 developed severe hepatitis that improved after treatment with corticosteroids. Liver tissue was available from two patients and showed histologic changes commonly associated with drug reactions.<bold>Conclusion: </bold>Patients receiving zafirlukast may develop severe liver injury and should be observed for signs and symptoms of hepatitis.
- Subjects
DRUG side effects; HEPATITIS treatment
- Publication
Annals of Internal Medicine, 2000, Vol 133, Issue 12, p964
- ISSN
0003-4819
- Publication type
journal article
- DOI
10.7326/0003-4819-133-12-200012190-00011