[Carbamazepine hepatoxicity--a case report]

Area of Science:

• Hepatology
• Pharmacology
• Adolescent Medicine

Background:

• Chronic hepatitis B infection poses risks for liver damage.
• Carbamazepine is an anticonvulsant medication with potential hepatotoxicity.
• Long-term drug therapy requires careful monitoring for adverse effects, especially in patients with pre-existing liver conditions.

Observation:

• A 16-year-old adolescent with chronic hepatitis B developed acute liver damage after three years of carbamazepine treatment.
• Clinical presentation included jaundice and significant biochemical abnormalities.
• Elevated bilirubin, AST, ALT, PA, GTP, INR, and blood ammonia levels were observed.

Findings:

• Carbamazepine therapy was associated with acute liver injury in this adolescent patient.
• The severity of liver damage was indicated by markedly elevated liver enzymes and bilirubin.
• Withdrawal of carbamazepine led to a notable improvement in liver function tests.

Implications:

• This case highlights the potential hepatotoxicity of carbamazepine, even in patients with chronic hepatitis B.
• It underscores the importance of vigilant monitoring of liver function in patients on long-term carbamazepine, particularly those with underlying liver disease.
• Clinicians should consider drug-induced liver injury when evaluating acute liver dysfunction in patients taking carbamazepine.