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[Fenofibrate-induced acute hepatitis with pseudo-cholangitis]
S Lelouch1, G Pelletier, M Sinico
1Service des Maladies du Foie et de l'Appareil Digestif, Hôpital de Bicêtre, Le Kremlin Bicêtre.
Gastroenterologie Clinique Et Biologique
|January 1, 1992
Summary
Fenofibrate may cause acute hepatitis, presenting with abdominal pain and fever. Drug withdrawal led to recovery, suggesting an immunoallergic reaction.
Area of Science:
- Hepatology
- Clinical Pharmacology
- Toxicology
Background:
- Fenofibrate is a commonly prescribed lipid-lowering agent.
- Drug-induced liver injury (DILI) is a significant clinical concern.
- Identifying specific drug culprits is crucial for patient safety.
Observation:
- A patient presented with acute hepatitis, characterized by abdominal pain and fever.
- Laboratory tests revealed elevated aminotransferases and alkaline phosphatase.
- Peripheral blood and liver biopsy showed high eosinophil counts.
Findings:
- Re-administration of fenofibrate (rechallenge) resulted in a relapse of hepatitis symptoms and liver enzyme abnormalities.
- The presence of eosinophils in blood and liver tissue suggests an immunoallergic mechanism.
- Discontinuation of fenofibrate led to rapid clinical improvement and normalization of liver tests.
Implications:
- This case highlights fenofibrate as a potential cause of acute, immunoallergic hepatitis.
- Clinicians should consider fenofibrate in the differential diagnosis of unexplained hepatitis.
- Prompt drug withdrawal is essential for managing fenofibrate-induced liver injury.