Disulfiram hepatotoxicity: a consideration of its mechanism and clinical spectrum

Disulfiram-induced hepatotoxicity is a recognised entity despite the difficulty in determining its contribution to the damage when alcoholism itself is a frequent cause of liver disease. Less well characterised is the mechanism of disulfiram-induced hepatotoxicity and the high fatality rate associated with this entity. The clinical spectrum of the disease is reviewed and experimental data suggesting the mechanism of toxicity are presented. Failure to recognise this problem and to terminate therapy as soon as possible may result in death due to massive hepatic necrosis.