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[Clometacine hepatitis. 2 cases (author's transl)]

C Lenoir, D Labayle, C Buffet

    La Nouvelle Presse Medicale
    |October 7, 1978
    PubMed
    Summary

    Clometacine medication caused liver damage (hepatitis) in two elderly women, indicated by elevated liver enzymes and eosinophils. One patient progressed to cirrhosis despite stopping the drug, suggesting a hypersensitivity reaction.

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    Area of Science:

    • Hepatology
    • Clinical Pharmacology
    • Immunology

    Background:

    • Clometacine, a non-steroidal anti-inflammatory drug (NSAID), is used for its analgesic and anti-inflammatory properties.
    • Drug-induced liver injury (DILI) is a significant concern in pharmacovigilance.
    • NSAIDs are known to cause a range of adverse hepatic reactions.

    Observation:

    • Two cases of hepatitis were observed in elderly women (72 and 78 years old) associated with clometacine use.
    • Key laboratory findings included elevated serum transaminases and increased blood eosinophil counts.
    • Histological examination in one case revealed aggressive chronic hepatitis-like lesions.

    Findings:

    • Clometacine was identified as the causative agent for hepatitis in both patients.
    • The clinical presentation and laboratory abnormalities suggest an immune-mediated mechanism.
    • Despite drug cessation, one patient experienced disease progression to cirrhosis, indicating severe hepatotoxicity.

    Implications:

    • This study highlights the potential for clometacine to cause severe, potentially irreversible liver injury.
    • The findings underscore the importance of monitoring liver function in patients taking clometacine, especially the elderly.
    • A hypersensitivity reaction is the likely mechanism, necessitating careful consideration of drug rechallenge.

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