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Joanne Lin1,2, David Braxton3, Tse-Ling Fong4

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This case study highlights a rare instance of febuxostat-induced liver injury in a gout patient. Monitoring liver function is crucial for individuals taking febuxostat.

Keywords:
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Area of Science:

  • Hepatology
  • Pharmacology

Background:

  • Febuxostat is a xanthine oxidase inhibitor for gout and hyperuricemia.
  • While generally safe, rare cases of drug-induced liver injury (DILI) are linked to febuxostat.

Purpose of the Study:

  • To report a case of liver injury following febuxostat initiation.
  • To underscore the importance of monitoring liver function in patients on febuxostat.

Main Methods:

  • Case report of a male patient in his late 50s.
  • Clinical presentation, laboratory tests, and liver biopsy findings were analyzed.
  • Response to febuxostat discontinuation and subsequent treatment with prednisone was documented.

Main Results:

  • The patient developed fatigue, nausea, jaundice, and elevated aminotransferases after switching to febuxostat.
  • Liver biopsy confirmed moderate acute hepatocellular injury.
  • Liver tests improved only after a month of discontinuation and subsequent prednisone treatment.

Conclusions:

  • This case contributes to the understanding of febuxostat-induced liver injury.
  • Clinical and histological presentations of febuxostat DILI can be variable.
  • Vigilant monitoring of liver tests is essential for patients prescribed febuxostat.