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Ketoconazole-induced liver damage
J A Findor1, J A Sorda, E B Igartua
1División de Gastroenterología, Hospital de Clínicas José de San Martín, Facultad de Medicina, Universidad de Buenos Aires, Argentina.
Medicina
|August 26, 1998
Summary
Ketoconazole can cause severe liver damage, leading to fatalities in some cases. Regular monitoring is crucial to detect early signs of hepatotoxicity during antifungal therapy.
Area of Science:
- Pharmacology
- Hepatology
- Mycology
Background:
- Ketoconazole is a widely used antifungal medication.
- Liver damage (hepatotoxicity) is a known, albeit rare, adverse effect of ketoconazole.
- This study examines clinical cases of ketoconazole-induced liver injury.
Observation:
- Five patients (4 female, 1 male) developed liver damage while on ketoconazole (400 mg/day) for mycoses.
- Hepatotoxicity signs appeared around four weeks into therapy in female patients.
- Two patients experienced fatal outcomes, one with fulminant liver failure and massive necrosis, the other with submassive necrosis.
Findings:
- Cholestasis was a significant finding in four out of five cases.
- Biochemical markers of biliary stasis persisted for months in surviving patients.
- Continued ketoconazole use despite adverse effects was noted in fatal cases.
Implications:
- Early and repeated monitoring for liver function is essential during ketoconazole treatment.
- Healthcare providers should be vigilant for signs of hepatotoxicity.
- Risk-benefit assessment is critical, especially in prolonged ketoconazole therapy.