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Gliclazide-induced acute hepatitis.

S P Dourakis1, E Tzemanakis, C Sinani

  • 1Academic Department of Medicine, Hippokration General Hospital, Athens, Greece.

European Journal of Gastroenterology & Hepatology
|February 3, 2000
PubMed
Summary

Gliclazide, a sulfonylurea for type 2 diabetes, can cause acute liver injury. This case report highlights the risk of drug-induced hepatitis, emphasizing prompt withdrawal for patient recovery.

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Area of Science:

  • Hepatology
  • Clinical Pharmacology
  • Endocrinology

Background:

  • Sulfonylureas are commonly prescribed for type 2 diabetes mellitus.
  • Hepatotoxicity is a rare but serious adverse effect associated with some sulfonylureas.
  • Gliclazide is a second-generation sulfonylurea with a generally favorable safety profile.

Observation:

  • A 60-year-old woman developed acute icteric hepatitis-like illness 6 weeks after starting gliclazide.
  • Exclusion of other causes of acute hepatocellular necrosis was performed.
  • Liver biopsy revealed portal and lobular inflammation, consistent with drug-induced hepatitis.

Findings:

  • Gliclazide was identified as the likely cause of acute hepatitis.
  • Withdrawal of gliclazide led to rapid clinical and biochemical recovery within 4 weeks.

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  • This represents a potential idiosyncratic adverse reaction to gliclazide.

    • Implications:

    • Gliclazide-induced acute hepatitis can mimic viral hepatitis, necessitating careful differential diagnosis.
    • Physicians should consider drug-induced liver injury in patients presenting with unexplained hepatitis.
    • Prompt discontinuation of gliclazide is crucial for managing this adverse event.