David M. Hachey, PharmD; Michael P. O'Neil, MD; Rex W. Force, PharmD, BCPS
Hachey D., O'Neil M., Force R.; Isolated Elevation of Alkaline Phosphatase Level Associated with Rosiglitazone. Ann Intern Med. 2000;133:752. doi: 10.7326/0003-4819-133-9-200011070-00035
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Published: Ann Intern Med. 2000;133(9):752.
TO THE EDITOR:
A 47-year-old woman with a history of type 2 diabetes mellitus, hypertension, herpes zoster, depression, and diabetic gastroparesis presented for follow-up and routine laboratory evaluation. Her physical examination was benign, and her hepatic function panel was normal except for a serum alkaline phosphatase level elevated five times the upper limit of normal (10.93 µkat/L). She had no history of liver disease, but approximately 1 year before presentation she had slightly elevated aminotransferase levels (alanine aminotransferase, 1283 nkat/L; aspartate aminotransferase, 0.73 µkat/L).
Her medication regimen included metformin, 850 mg three times daily; sertraline, 50 mg/d; losartan, 50 mg twice daily; estropipate, 1.25 mg/d; and rosiglitazone, 4 mg/d. Results of liver function tests 4 months earlier were all normal (alkaline phosphatase level, 1.13 µkat/L) when rosiglitazone was added to her regimen. During the intervening period, the patient was asymptomatic and no other medications were added to or removed from her regimen. Because rosiglitazone was the only change in her medications, it was suspected to be the offending agent. Rosiglitazone therapy was discontinued, and 2 weeks later her alkaline phosphate levels returned to normal (1.03 µkat/L). Rechallenge was not done.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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