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Trimethoprim-Sulfamethoxazole-induced Hepatotoxicity in a Renal Transplant Patient

R Slim1, N Asmar1, C Yaghi1

  • 1Department of Gastroenterology, Hotel-Dieu de France Hospital, Saint Joseph University, Beirut, Lebanon.

Indian Journal of Nephrology
|December 9, 2017
PubMed

Insights

Drug-induced liver injury (DILI) from antimicrobials is a concern. This case highlights rare hepatic toxicity from Trimethoprim-sulfamethoxazole (TMP-SMX) post-renal transplant, emphasizing its unpredictable nature.

Area of Science:

  • Hepatology
  • Pharmacology
  • Nephrology

Background:

  • Drug-induced liver injury (DILI) is a significant clinical issue, with antimicrobials being frequent culprits.
  • Renal transplantation patients are often on multiple medications, increasing the risk of DILI.

Observation:

  • A case of DILI is presented in a renal transplant recipient.
  • The patient developed liver injury attributed to Trimethoprim-sulfamethoxazole (TMP-SMX) therapy.

Findings:

  • Diagnosis of TMP-SMX-induced liver toxicity was confirmed by excluding other causes and observing biochemical improvement upon drug withdrawal.
  • While TMP-SMX hepatotoxicity is documented, its occurrence in this context is rare and unpredictable.

Implications:

  • This case underscores the importance of vigilant monitoring for DILI in transplant patients receiving TMP-SMX.
  • Awareness of rare but severe drug reactions is crucial for optimizing patient management and outcomes.
Keywords:
Hepatotoxicityrenal transplanttrimethoprim-sulfamethoxazole

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