Significant Hyperbilirubinemia and Acute Hepatocellular Jaundice in a Pediatric Patient Receiving Deferasirox: A Case...

Area of Science:

• Hepatology
• Pharmacology
• Pediatrics

Background:

• Deferasirox is a widely used iron chelator for managing chronic transfusional iron overload.
• Postmarketing surveillance has noted hepatic injury associated with deferasirox, particularly in older adults with comorbidities.
• The precise incidence and risk factors in pediatric populations remain less well-defined.

Observation:

• A 7-year-old female patient developed severe hyperbilirubinemia and acute hepatocellular jaundice.
• The patient was undergoing treatment for iron overload due to chronic transfusions.
• No pre-existing risk factors for liver injury were identified in this patient.

Findings:

• Causality assessment using the Roussel Uclaf Causality Assessment Method indicated a probable link between deferasirox and the observed liver injury.
• Exclusion of alternative causes of liver injury strengthens the association with deferasirox.
• This case represents a unique presentation of deferasirox-induced hepatotoxicity in a young patient without typical risk factors.

Implications:

• This case underscores the potential for deferasirox to cause significant hepatic injury in pediatric patients, irrespective of age or comorbidities.
• Highlights the need for vigilant liver function monitoring in all patients receiving deferasirox.
• Suggests a broader spectrum of deferasirox-associated hepatotoxicity than previously characterized, necessitating further investigation into pediatric risk stratification.