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Acute hepatitis due to buprenorphine administration
Sophie Hervé1, Ghassan Riachi, Catherine Noblet
1Digestive Tract Research Group ADEN-EA3234/IFRMP23, Rouen University Hospital, France. Sophie.herve@chu-rouen.fr
European Journal of Gastroenterology & Hepatology
|September 17, 2004
Summary
Buprenorphine, used for opiate dependence treatment, can cause acute liver injury (hepatitis) in some patients. While rare and typically resolving, monitoring liver function is crucial, especially in those with pre-existing liver conditions.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Buprenorphine, a synthetic opiate derivative, has been used since 1987 for opioid dependence treatment in France.
- Hepatotoxicity associated with buprenorphine is infrequently documented, with limited reported cases of liver injury.
Purpose of the Study:
- To report and analyze seven cases of acute cytolytic hepatitis attributed to buprenorphine use.
- To investigate the clinical presentation, laboratory findings, and outcomes of buprenorphine-induced liver injury.
Main Methods:
- Retrospective analysis of seven patients who developed acute hepatitis while on buprenorphine withdrawal therapy.
- Inclusion of liver function tests, viral screening (Hepatitis C), and abdominal CT scans for patient evaluation.
Main Results:
- Five of seven patients presented with acute icteric hepatitis, characterized by elevated ALT levels (39x normal) without fever or pain.
- All patients had positive Hepatitis C serology; two were also positive for Hepatitis C virus-RNA.
- Rapid resolution of cytolysis and jaundice occurred in all cases, irrespective of buprenorphine dosage adjustments.
Conclusions:
- Buprenorphine-induced hepatitis, though uncommon, typically shows a favorable spontaneous evolution.
- Enhanced monitoring of liver function is recommended for patients on buprenorphine, particularly those with compromised mitochondrial function due to viral infections or other toxins.