Silvio Danese, MD; Italo De Vitis, MD; Antonio Gasbarrini, MD
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Danese S., De Vitis I., Gasbarrini A.; Severe Liver Injury Associated with Zafirlukast. Ann Intern Med. 2001;135:930. doi: 10.7326/0003-4819-135-10-200111200-00023
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Published: Ann Intern Med. 2001;135(10):930.
TO THE EDITOR:
We read with interest the paper by Reinus and coworkers on three cases of severe liver injury after administration of the leukotriene receptor antagonist zafirlukast (1). We report a similar case of a 55-year-old woman who developed severe hepatitis after zafirlukast administration. She was admitted to the hospital with nausea, vomiting, fatigue, and mild abdominal pain in the right upper quadrant. She was taking zafirlukast, 20 mg twice per day for 5 months, and albuterol sulfate nasal spray.
Levels of aspartate aminotransferase (10.92 µkat/L [655 U/L]) and alanine aminotransferase (20 217 nkat/L [1213 U/L]) were elevated. (Normal ranges are 0.12 to 0.75 µkat/L [7 to 45 U/L] and 117 to 750 nkat/L [7 to 45 U/L], respectively.) The patient had elevated levels of total γ-glutamyltransferase (12.15 µkat/L [normal range, 0.08 to 0.75 µkat/L]), with an elevated γ-glutamyltransferase isoform specific for drug- and alcohol-related liver toxicity. Before administration of zafirlukast, results of liver tests had been normal.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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