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Flucloxacillin-Induced Hepatotoxicity - Association with HLA-B*5701.

Mónica Teixeira¹, Sara Macedo¹, Tânia Batista¹

¹. Internal Medicine Physician with Specific Training in Internal Medicine, Tondela-Viseu Hospital Center, Viseu, Portugal.

Revista Da Associacao Medica Brasileira (1992)

|March 5, 2020

Summary

Drug-induced liver injury from flucloxacillin is rare but can be severe. This case highlights the importance of considering flucloxacillin-induced liver injury, especially in patients with the HLA-B*5701 allele.

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Area of Science:

Hepatology
Pharmacology
Genetics

Background:

Drug-induced liver injury (DILI) is an idiosyncratic reaction.
Flucloxacillin is a commonly used antibiotic.
Individual susceptibility influences DILI occurrence.

Observation:

A 74-year-old man presented with symptoms of liver injury after flucloxacillin treatment.
Laboratory tests revealed significant elevations in liver enzymes and bilirubin.
Liver biopsy showed centrilobular changes and portal inflammation.
The patient tested positive for the HLA-B*5701 allele.

Findings:

The patient was diagnosed with flucloxacillin-induced liver injury.
Treatment with ursodeoxycholic acid led to a favorable, albeit slow, recovery.
The case underscores the potential for moderate to severe liver injury from flucloxacillin.

Implications:

Highlights the association between flucloxacillin DILI and the HLA-B*5701 allele.
Emphasizes the need for vigilance regarding flucloxacillin-induced liver injury in clinical practice.
Suggests genetic screening may be beneficial in identifying susceptible individuals.