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Hepatocellular Injury in a Patient Receiving Rosiglitazone: A Case Report

Jameela Al-Salman, MD; Heider Arjomand, MD; David G. Kemp, MD; and Manoj Mittal, MD
[+] Article and Author Information

From Easton Hospital, MCP-Hahnemann University, Easton, Pennsylvania.


Requests for Reprints: Manoj K. Mittal, MD, Division of Gastroenterology, Easton Hospital, 250 South 21st Street, Easton, PA 18042. For reprint orders in quantities exceeding 100, please contact the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints@mail.acponline.org.

Current Author Addresses: Drs. Al-Salman, Arjomand, and Kemp: Department of Medicine, Easton Hospital, 250 South 21st Street, Easton, PA 18042.

Dr. Mittal: Division of Gastroenterology, Easton Hospital, 250 South 21st Street, Easton, PA 18042.

Author Contributions: Conception and design: J. Al-Salman, H. Arjomand.

Analysis and interpretation of data: J. Al-Salman, H. Arjomand, D.G. Kemp.

Drafting of the article: J. Al-Salman, H. Arjomand.

Critical revision of the article for important intellectual content: J. Al-Salman, H. Arjomand, D.G. Kemp.

Final approval of the article: J. Al-Salman, H. Arjomand, D.G. Kemp, M.K. Mittal.

Provision of study materials or patients: D.G. Kemp.

Administrative, technical, or logistic support: D.G. Kemp.

Collection and assembly of data: J. Al-Salman, H. Arjomand, D.G. Kemp.


Ann Intern Med. 2000;132(2):121-124. doi:10.7326/0003-4819-132-2-200001180-00006
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Background: Rosiglitazone maleate (Avandia, SmithKline Beecham, Philadelphia, Pennsylvania) is a new oral hypoglycemic agent approved for the treatment of type 2 diabetes. It acts primarily by increasing insulin sensitivity. In controlled trials, there has been no evidence of rosiglitazone-induced hepatocellular injury.

Objective: To report a case of hepatocellular injury in a patient receiving rosiglitazone.

Design: Case report.

Setting: Community teaching hospital.

Patient: 61-year-old man receiving rosiglitazone, 4 mg/d for 2 weeks.

Intervention: Discontinuation of rosiglitazone therapy.

Measurements: Clinical evaluation and assessment of liver function test results were done daily during hospitalization and periodically after discharge. The outpatient record was also reviewed.

Results: After receiving rosiglitazone for 2 weeks, the patient presented with anorexia, vomiting, and abdominal pain. Liver function tests revealed severe hepatocellular injury. Discontinuation of rosiglitazone therapy led to rapid improvement of liver function and resolution of symptoms.

Conclusion: Rosiglitazone may be associated with hepatocellular injury. We believe that patients receiving rosiglitazone should have liver enzyme levels monitored earlier and more frequently than initially recommended.

Figures

Grahic Jump Location
Figure.
Alanine aminotransferase levels over time.

The patient was hospitalized 25 June 1999 through 2 July 1999. To convert U/L to nkat/L, multiply by 16.667.

Grahic Jump Location

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Summary for Patients

Liver Injury in a Person Taking the Diabetes Drug Rosiglitazone

The summary below is from the full report titled “Hepatocellular Injury in a Patient Receiving Rosiglitazone. A Case Report” It is in the 18 January 1999 issue of Annals of Internal Medicine (volume 131, pages 121-124). The authors are J. Al-Salman, H. Arjomand, D.G. Kemp, and M. Mittal.

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