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Fulminant Hepatic Failure Associated with 2′,3′-Dideoxyinosine (ddI)

Kwan Kew Lai, DMD, MD; David L. Gang, MD; John K. Zawacki, MD; and Timothy P. Cooley, MD
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Requests for Reprints: Kwan Kew Lai, DMD, MD, Division of Infectious Disease and Immunology, Department of Medicine, University of Massachusetts Medical Center, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655.

Current Author Addresses: Drs. Lai, Gang, and Zawacki: University of Massachusetts Medical Center, 55 Lake Avenue North, Worcester, MA 01655.

Dr. Cooley: Division of Hematology-Oncology and Clinical AIDS Service, Department of Medicine, FGH-1, Boston City Hospital, Boston University School of Medicine, 818 Harrison Avenue, Boston, MA 02118.

Ann Intern Med. 1991;115(4):283-284. doi:10.7326/0003-4819-115-4-283
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Results from recently published phase I trials (1-3) of 2′,3′-dideoxyinosine (didanosine, ddI) show promise in the treatment of patients with the acquired immunodeficiency syndrome (AIDS) and AIDS-related complex; ddI is currently being evaluated in phase II-III clinical trials and is widely available in an expanded access program. The major clinical toxicities associated with ddI include peripheral neuropathy and pancreatitis. Deaths have been associated with severe cases of pancreatitis. Laboratory abnormalities include hyperuricemia and elevated levels of hepatic aminotransferases. We report a patient with fulminant hepatic failure associated with the use of ddI.

A 36-year-old homosexual man with the Gilbert syndrome,


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