The full content of Annals is available to subscribers

Subscribe/Learn More  >
Brief Communications |

Two Cases of Severe Clinical and Histologic Hepatotoxicity Associated with Troglitazone

Norman Gitlin, MD; Neil L. Julie, MD; Charles L. Spurr, MD; Kie N. Lim, MD; and Herbert M. Juarbe, MD
[+] Article, Author, and Disclosure Information

From Emory University School of Medicine and Shady Grove Adventist Hospital, Atlanta, Georgia. Requests for Reprints: Norman Gitlin, MD, Emory University School of Medicine, Division of Digestive Diseases, WMB 2101, Pierce Drive, Atlanta, GA 30322. Current Author Addresses: Drs. Gitlin and Lin: Emory University School of Medicine, Division of Digestive Diseases, WMB 2101, Pierce Drive, Atlanta, GA 30322.

Copyright ©2004 by the American College of Physicians

Ann Intern Med. 1998;129(1):36-38. doi:10.7326/0003-4819-129-1-199807010-00008
Text Size: A A A

Several oral antihyperglycemic agents are available for management of type 2 diabetes. These agents generally fall into the chemical or function groups sulfonylureas, biguanides, or α-glucosidase inhibitors. Recently, the U.S. Food and Drug Administration approved troglitazone (Rezulin, Parke-Davis, Morris Plains, New Jersey), a thiazolidinedione agent that is unrelated to the aforementioned categories, as a novel oral antihyperglycemic agent. It decreases hepatic glucose output and increases insulin-dependent glucose metabolism in skeletal muscle [12]. It is not an insulin secretagogue. We report two patients who had severe hepatotoxicity associated with troglitazone administration.

First Page Preview

View Large
First page PDF preview


Grahic Jump Location
Figure 1.
Low-power view of portal tract showing interface hepatitis, mild inflammatory infiltrate, bile duct reduplication, and necrotic hepatocytes (hematoxylin-eosin stain; original magnification, x96).
Grahic Jump Location




Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).


Submit a Comment/Letter
Submit a Comment/Letter

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.


Buy Now for $32.00

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.