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Hepatic necrosis with cholestasis induced by long-term voglibose administration
S Kawakami1, T Arima, K Harada
1Takaharu Town Hospital, Miyazaki.
Internal Medicine (Tokyo, Japan)
|July 12, 2001
Summary
Voglibose, a diabetes medication, may cause drug-induced liver injury. Discontinuation and corticosteroid treatment led to recovery, highlighting the need for vigilant patient monitoring.
Area of Science:
- Hepatology
- Pharmacology
- Internal Medicine
Background:
- Diabetes mellitus management often involves multiple oral hypoglycemic agents.
- Voglibose is an alpha-glucosidase inhibitor used to treat type 2 diabetes.
- Drug-induced liver injury (DILI) is a significant concern in pharmacotherapy.
Observation:
- A 76-year-old female patient developed jaundice during treatment with insulin and voglibose.
- Liver function tests normalized after discontinuing voglibose and initiating corticosteroid therapy.
- In vitro lymphocyte stimulation assays indicated a hypersensitivity reaction to voglibose.
Findings:
- The patient's liver biopsy revealed cholestasis with submassive and zonal necrosis.
- Follow-up liver biopsy after 1 year showed complete resolution of liver damage.
- The clinical presentation and laboratory findings strongly suggest voglibose-induced liver injury.
Implications:
- Healthcare providers should consider voglibose as a potential cause of DILI in patients presenting with jaundice.
- Long-term monitoring of liver function, including serum transaminases and bilirubin, is crucial for patients on voglibose.
- Prompt discontinuation of the offending drug and appropriate medical management can lead to favorable outcomes in DILI.
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