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Pemoline therapy resulting in liver transplantation
K G Adcock1, D E MacElroy, E T Wolford
1University of North Carolina Hospitals and Clinics, Chapel Hill 27514, USA.
The Annals of Pharmacotherapy
|April 30, 1998
Summary
Pemoline, used for attention deficit/hyperactivity disorder (ADHD), can cause severe liver failure requiring transplantation, especially in children. This case highlights the drug
Area of Science:
- Hepatology
- Pediatric Gastroenterology
- Pharmacology
Background:
- Pemoline is a medication historically used for Attention Deficit/Hyperactivity Disorder (ADHD).
- Hepatotoxicity has been a reported, albeit rare, adverse effect associated with pemoline treatment.
- The exact mechanism underlying pemoline-induced liver injury remains incompletely understood.
Observation:
- A 9-year-old boy with ADHD developed acute liver failure during pemoline therapy.
- Despite discontinuation of pemoline, the patient's liver function deteriorated.
- Liver transplantation became necessary due to the severity of the pemoline-induced liver failure.
Findings:
- This case represents the second reported instance of pemoline-induced liver failure necessitating liver transplantation.
- Pediatric patients appear to be particularly susceptible to pemoline-associated hepatotoxicity.
- Potential mechanisms include hypersensitivity, dose-related toxicity, or autoimmune reactions.
Implications:
- Pemoline should not be considered a first-line treatment for ADHD due to the risk of severe liver injury.
- Baseline and regular monitoring of liver function tests are crucial for patients on pemoline.
- Educating patients and caregivers about the signs and symptoms of liver toxicity is essential for early detection and intervention.
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