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Zafirlukast-induced acute hepatitis
Chien-Wei Su1, Jaw-Ching Wu, Yi-Hsiang Huang
1Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan ROC.
Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|February 14, 2003
Summary
Zafirlukast, an asthma medication, can cause drug-induced liver injury. Discontinuation of zafirlukast led to patient recovery, highlighting the need for careful monitoring.
Area of Science:
- Hepatology
- Pharmacology
- Clinical Medicine
Background:
- Zafirlukast is a cysteinyl leukotriene receptor antagonist used for asthma management.
- It was previously considered to have an adverse event profile similar to placebo.
Observation:
- A 69-year-old female developed malaise, nausea, and jaundice after 3 months of zafirlukast therapy.
- The patient had no prior history of liver disease, alcoholism, or other risk factors.
- Elevated liver enzymes (ALT, AST) and bilirubin levels were observed.
Findings:
- Viral hepatitis markers and autoimmune antibodies were negative, ruling out other causes of liver injury.
- Causality assessment confirmed zafirlukast as the cause of drug-induced liver injury (DILI).
- Liver function normalized after zafirlukast discontinuation.
Implications:
- Zafirlukast presents a potential risk of hepatotoxicity.
- Clinicians should monitor liver biochemistries in patients taking zafirlukast.
- Prompt discontinuation of zafirlukast is crucial if DILI is suspected.