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[Cholestatic hepatitis caused by ketoconazole].

R J Bensaude1, Y Furet, E Autret

  • 1Clinique Saint-Grégoire, Tours.

Annales De Gastroenterologie Et D'Hepatologie
|March 1, 1988
PubMed
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This case report details a rare instance of Ketoconazole-induced hepatitis, presenting as cholestatic injury. The idiosyncratic mechanism suggests careful consideration of this antifungal therapy.

Area of Science:

  • Hepatology
  • Pharmacology
  • Toxicology

Background:

  • Ketoconazole is a widely used antifungal medication.
  • Drug-induced liver injury (DILI) is a significant clinical concern.
  • Cholestatic patterns of liver injury can result from various medications.

Observation:

  • A 62-year-old female developed cholestatic hepatitis after a short duration of low-dose Ketoconazole therapy (200 mg/day).
  • Clinical, biochemical, and histological findings were consistent with a cholestatic injury pattern.
  • Recovery occurred after discontinuation of Ketoconazole.

Findings:

  • The rapid onset and lack of immune markers suggest an idiosyncratic reaction rather than an immune-mediated response.
  • Ketoconazole-induced hepatitis, particularly with a cholestatic profile, appears to be a rare but potential adverse effect.

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  • The injury mechanism may be idiosyncratic, implying unpredictable susceptibility in patients.

    • Implications:

    • Healthcare providers should be aware of the potential for Ketoconazole-induced cholestatic hepatitis, even with standard dosing.
    • Prompt recognition and cessation of Ketoconazole are crucial for patient recovery.
    • Further research into the idiosyncratic mechanisms of Ketoconazole hepatotoxicity is warranted.