[Clofibrate hepatitis. A case report].

Area of Science:

• Hepatology
• Clinical Pharmacology
• Drug-Induced Liver Injury (DILI)

Background:

• Clofarabine is a lipid-lowering agent used to manage hyperlipidemia.
• Drug-induced liver injury (DILI) is a significant concern in pharmacotherapy, presenting diagnostic challenges.

Observation:

• A patient experienced hepatitis during clofibrate therapy.
• The hepatitis resolved upon discontinuation of clofibrate.
• Recurrent hepatitis symptoms emerged upon subsequent exposure to fenofibrate, a structurally related drug.

Findings:

• The patient's hepatitis was temporally associated with clofibrate use.
• The resolution of hepatitis after drug withdrawal and recurrence upon rechallenge strongly suggests a causal link.
• Fenofibrate, a fibrate derivative, also triggered a similar hepatic reaction, supporting a class effect or cross-reactivity.

Implications:

• This case highlights the potential for clofibrate and related fibrates to cause drug-induced hepatitis.
• Clinicians should consider fibrate-induced liver injury in patients presenting with unexplained hepatitis.
• Careful monitoring and consideration of alternative lipid-lowering agents may be warranted in susceptible individuals.