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[Ketoconazole-induced hepatitis. Case report]
Abstract:
Since Oct. 1981 a new systemic antifungal drug Ketoconazole is available in the Federal Republic of Germany that has proven effective even in severe cases with fungal infections. This case-study will call attention on a rare but important side effect, namely Ketoconazole induced hepatitis. As an acute icteric viral hepatitis, type Non-A-Non-B-hepatitis possibly misdiagnosed only a carefully compiled history of the recent intake of drugs points at the real cause of hepatitis. In our case-report we observed a considerable increase in serum enzymes, especially GOT, GPT and GLDH after a drug-challenge with two tablets. We recommend so-called liver functions tests 2 to 3 weeks after beginning of therapy and further-on in monthly intervals. Histologically at that time toxic hydropic changes of the liver cells and a mesenchymal reaction with portal and intralobular mainly eosinophilic infiltration could be established. The serum enzymes came to normal only after 12 weeks.
Insights
Ketoconazole, an antifungal drug, can cause rare but serious liver damage (hepatitis). Monitoring liver function tests is crucial during treatment to detect this side effect early.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Ketoconazole is a systemic antifungal agent effective for severe fungal infections.
- Hepatotoxicity is a rare but significant adverse effect associated with Ketoconazole therapy.
Observation:
- This case study highlights Ketoconazole-induced hepatitis, which can mimic viral hepatitis (e.g., Non-A-Non-B).
- A drug challenge with Ketoconazole led to a marked increase in serum enzymes including GOT, GPT, and GLDH.
Findings:
- Histological examination revealed toxic hydropic changes in hepatocytes and inflammatory infiltration.
- Serum enzyme levels normalized approximately 12 weeks after discontinuing the drug.
Implications:
- Clinicians should consider drug-induced liver injury in patients presenting with hepatitis symptoms.
- Regular liver function monitoring is recommended 2-3 weeks after initiating Ketoconazole therapy and monthly thereafter.