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Updated: May 26, 2026

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Human Liver Microphysiological System for Assessing Drug-Induced Liver Toxicity In Vitro

Published on: January 31, 2022

Temozolomide induced liver injury.

Sanjay Dixit¹, Mohan Hingorani, Ponnambath Afzal

¹Castle Hill Hospital, Hull, UK. sanjay.dixit@hey.nhs.uk

Acta Neurologica Belgica

|December 7, 2011

Summary

Temozolomide (TMZ) can cause severe liver injury, presenting as cholestasis, in Glioblastoma patients. This case highlights a rare instance of drug-induced liver injury (DILI) from TMZ, emphasizing the need for vigilant monitoring.

Area of Science:

Hepatology
Oncology
Clinical Pharmacology

Background:

Glioblastoma (GB) is a primary brain tumor often treated with radiotherapy and chemotherapy.
Temozolomide (TMZ) is a common chemotherapeutic agent used in GB treatment.
Drug-induced liver injury (DILI) is a potential adverse effect of various medications.

Observation:

A 62-year-old female patient with GB developed severe liver dysfunction during radiotherapy with daily TMZ.
Histopathology revealed acute cholestasis and focal parenchymal inflammation, with no other identifiable cause.
The patient experienced grade three hepatic failure requiring prolonged hospitalization and slow liver function recovery.

Findings:

This case represents a potential instance of Temozolomide-induced liver injury (TMZ-DILI), characterized by cholestasis.

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The observed liver injury pattern differs from Dacarbazine-induced veno-occlusive liver damage.

The Naranjo Adverse Drug Reaction (ADR) probability scale indicated a probable grade (Scale 7) for TMZ-DILI.

Implications:

This case underscores the rare but serious hepatotoxicity associated with Temozolomide.
Clinicians should consider TMZ-DILI in patients presenting with unexplained liver enzyme elevation during treatment.
Further research is warranted to elucidate the mechanisms and incidence of TMZ-induced liver injury.