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- Title
Increased aminotransferases do not necessarily mean hepatotoxicity of CFTR modulator therapy.
- Authors
Woynarowski, Marek; Sapiejka, Ewa; Jóźwiak, Maria; Wierzbicka-Rucińska, Aldona
- Abstract
Aim of the study: The presence of macroenzymes may mimic treatment related hepatotoxicity. Material and methods: We present a female subject who developed high alanine aminotransferase (ALT)/aspartate aminotransferase (AST) activity during cystic fibrosis transmembrane regulator (CFTR) modulator therapy. Results: The differential work-up did not show any underlying liver disease. CFTR modulators were stopped with subsequent normalization and immediate rise of ALT/AST after modulators were restarted, which was interpreted as the presentation of CFTR modulator hepatotoxicity. Before permanent CFTR modulators' discontinuation the patient's blood was tested for the presence of macroALT/macroAST and the result was positive. The patient is continuing a CFTR modulator treatment that is being supervised using standard laboratory tests and a test detecting the presence of macroenzymes. At three subsequent measurements the tests showed the presence of macroenzymes. Conclusions: Our patient shows that increased ALT/AST during CFTR modulator therapy may be related to the induction of macroenzymes and not necessarily to hepatotoxicity. Patients with high ALT/AST activity should be considered for testing for the presence of macroenzymes.
- Subjects
AMINOTRANSFERASES; HEPATOTOXICOLOGY; CYSTIC fibrosis; IMMUNOMODULATORS; LIVER enzymes
- Publication
Clinical & Experimental Hepatology, 2023, Vol 9, Issue 4, p405
- ISSN
2392-1099
- Publication type
Article
- DOI
10.5114/ceh.2023.132264