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[Acute hepatitis associated with terbinafine]

S Vivas¹, M Rodríguez, M A Palacio

¹Servicio de Aparato Digestivo, Hospital Central de Asturias, Oviedo.

Gastroenterologia Y Hepatologia

|January 31, 1998

Summary

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A rare case of toxic hepatitis linked to oral terbinafine, an antifungal medication, is presented. This drug-induced liver injury showed cholestasis and prolonged enzyme changes, likely due to an idiosyncratic reaction.

Area of Science:

Hepatology
Pharmacology
Toxicology

Background:

Oral terbinafine is an antifungal agent with a generally favorable safety profile.
Rare instances of liver involvement have been reported with terbinafine use.

Observation:

A case of toxic hepatitis developed in a patient after starting oral terbinafine.
The patient had no prior history of liver disease.
Histologic examination revealed a mixed liver lesion with a cholestatic predominance.

Findings:

Terbinafine administration was followed by significant liver enzyme alterations.
An initial worsening of liver function was observed after drug discontinuation.
Enzymatic alterations normalized over a one-year period.

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Implications:

This case highlights the potential for idiosyncratic liver injury from oral terbinafine.
Physicians should monitor liver function in patients receiving terbinafine, especially those with risk factors.
Further research into the mechanisms of terbinafine-induced hepatotoxicity is warranted.