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Terbinafine-induced cholestatic liver disease
G A Lazaros1, G V Papatheodoridis, J K Delladetsima
1First Department of Medicine, Western Attica General Hospital, Athens, Greece.
Journal of Hepatology
|June 1, 1996
Summary
Oral terbinafine rarely causes liver issues. This case highlights prolonged cholestatic liver disease from terbinafine, emphasizing the need for awareness in managing drug-induced liver injury.
Area of Science:
- Hepatology
- Pharmacology
- Toxicology
Background:
- Oral terbinafine is a widely used antifungal medication.
- Hepatobiliary disorders are rare but serious adverse effects associated with terbinafine.
- Distinguishing drug-induced liver injury from other liver conditions is crucial for proper management.
Observation:
- A case of prolonged cholestatic liver disease potentially induced by oral terbinafine is presented.
- Other potential causes of liver disease, including extrahepatic cholestasis, viral hepatitis, and autoimmune liver disorders, were ruled out.
- Histological examination revealed significant cholestasis without signs of biliary obstruction or acute hepatitis.
Findings:
- The clinical and histological features strongly supported a diagnosis of drug-induced liver disease.
- Biochemical markers of liver injury gradually normalized over a 6-month period following discontinuation of terbinafine.
- This case underscores the potential for terbinafine to cause prolonged cholestatic liver injury.
Implications:
- Clinicians should maintain a high index of suspicion for drug-induced liver injury in patients presenting with cholestatic liver disease, especially those on terbinafine.
- Prompt recognition and cessation of the offending agent are critical for favorable outcomes in terbinafine-induced liver injury.
- Further research into the mechanisms and risk factors for terbinafine hepatotoxicity is warranted.