Gliclazide-induced acute hepatitis : European Journal of Gastroenterology & Hepatology (original) (raw)
Case Reports: Gliclazide-induced acute hepatitis: PDF Only
Dourakis, Spyros P.; Tzemanakis, Eftichios; Sinani, Chrisanthi; Kafiri, Georgie; Hadziyannis, Stephanos J.
Academic Department of Medicine, Hippokration General Hospital, Athens, Greece
Correspondence to Prof. Stephanos J. Hadziyannis, Academic Department of Medicine, Hippokration General Hospital, GR 11515 Athens, Greece Tel: +30 1 777 4742; fax: +30 1 770 6871
Received 27 October 1998 Revised 30 November 1998
Accepted 30 April 1999
Abstract
There are few reports in the literature related to sulfonylurea-induced hepatotoxicity. We describe the case of acute hepatitis induced by gliclazide, a second generation sulfonylurea. A 60-year-old woman with diabetes mellitus (type 2) developed an acute icteric hepatitis-like illness 6 weeks after the initiation of gliclazide therapy. Other causes of acute hepatocellular necrosis were excluded. Liver histology showed marked portal inflammation with lymphocytes, monocytes and eosinophils, associated with lobular inflammation (indicative of a histological pattern consistent with drug-induced hepatitis). The drug was immediately withdrawn and the patient was given glibenclamide. The patient recovered clinically and, in less than 4 weeks, her serum bilirubin and aminotransferases returned to normal levels. We believe that this is the first description of acute hepatitis caused by an idiosyncratic adverse reaction to gliclazide or to one of its metabolites. In conclusion, this case strongly suggests that gliclazide can induce acute icteric liver necro-inflammation which may be misdiagnosed clinically as acute viral hepatitis. In patients who show abnormal liver function tests, the immediate discontinuation of gliclazide is recommended. Eur J Gastroenterol Hepatol 12:119-121 © 2000 Lippincott Williams & Wilkins
European Journal of Gastroenterology & Hepatology 2000, 12:119-121
© 2000 Lippincott Williams & Wilkins, Inc.