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Induction of Drug-Induced, Autoimmune Hepatitis in BALB/c Mice for the Study of Its Pathogenic Mechanisms
Published on: May 29, 2020
Atomoxetine-induced hepatitis in a child
Sasko D Stojanovski1, Marcel J Casavant, Hayat M Mousa
1College of Pharmacy, Ohio State University and Children's Research Institute, Columbus, Ohio 43210, USA.
Clinical Toxicology (Philadelphia, Pa.)
|March 16, 2007
Summary
Atomoxetine hydrochloride, used for attention deficit hyperactivity disorder (ADHD), has been linked to severe hepatitis in children. This case highlights the potential for serious liver injury, emphasizing the need for careful monitoring during treatment.
Area of Science:
- Pediatric Hepatology
- Clinical Pharmacology
- Neurodevelopmental Disorders
Background:
- Atomoxetine hydrochloride is a selective norepinephrine reuptake inhibitor commonly prescribed for Attention Deficit Hyperactivity Disorder (ADHD).
- Drug-induced liver injury (DILI) is a significant concern in pediatric pharmacotherapy.
- Hepatitis associated with atomoxetine has been reported, but severe cases require further documentation.
Observation:
- A severe case of hepatitis occurred in an 8-year-old female treated with atomoxetine hydrochloride for ADHD.
- The patient presented with elevated transaminases and bilirubin, abdominal pain, and emesis.
- Liver biopsy confirmed hepatitis with moderate piecemeal necrosis.
Findings:
- Causality assessment using standardized scales (International Organization of Medical Science Diagnostic Scale and Naranjo scale) indicated a 'probable' association between atomoxetine use and hepatitis.
- Discontinuation of atomoxetine and supportive care led to clinical improvement and normalization of liver function tests within 13 days.
- This represents a previously unpublished severe case of atomoxetine-induced hepatitis.
Implications:
- Clinicians should consider atomoxetine-induced hepatitis as a potential diagnosis in children presenting with liver dysfunction.
- Vigilant monitoring of liver function is crucial for pediatric patients receiving atomoxetine therapy.
- Further research into the mechanisms and incidence of atomoxetine-related hepatotoxicity is warranted.
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