Skip Navigation
Menu
Editorials |19 March 2002

“Did This Drug Cause My Patient's Hepatitis?” and Related Questions

David W. Nierenberg, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • Dartmouth Medical School; Hanover, NH 03755

    Requests for Single Reprints: David W. Nierenberg, MD, Section of Clinical Pharmacology, Departments of Medicine and Pharmacology–Toxicology, Dartmouth–Hitchcock Medical Center, 1 Medical Center Drive, Hinman Box 7506, Lebanon, NH 03756; e-mail, David.Nierenberg@Dartmouth.edu.

×
FULL TEXT
What should the busy internist do when his or her patient, while taking several medications, suddenly develops a new clinical problem, such as hepatitis? Is the acute hepatitis drug related? If so, which drug is to blame?
The case report by May and colleagues in this issue (1) describes a 49-year-old electrician who developed acute scleral icterus and moderate biochemical hepatitis (total bilirubin level, 8.0 times the upper limit of normal; alanine aminotransferase [ALT] level, 6.8 times the upper limit of normal). The patient had been receiving several medications for years; he began taking pioglitazone, first at a low dosage (15 to 30 mg/d) for 6 months and later at a higher dosage (45 mg/d), for 1 week. Because the authors suspected that pioglitazone was the causal agent, they discontinued use of that medication; they continued all the others. The result of a thorough evaluation for other common causes of hepatitis (including other medications) was negative, and a liver biopsy showed a pattern of mixed hepatocellular–cholestatic injury compatible with drug hepatotoxicity. Liver function tests showed considerable improvement 2 weeks after pioglitazone therapy was discontinued. The authors concluded that the hepatitis was probably caused by pioglitazone, even though only one other similar case had been reported previously.
FULL TEXT
PDF
Not Available
Citations
Citation

Nierenberg DW. “Did This Drug Cause My Patient's Hepatitis?” and Related Questions. Ann Intern Med. ;136:480–483. doi: 10.7326/0003-4819-136-6-200203190-00013

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 2002;136(6):480-483.

DOI: 10.7326/0003-4819-136-6-200203190-00013

©
2002 American College of Physicians
9 Citations

Related Articles
Drug Reactions and Your Duty
Annals of Internal Medicine; 64 (6): 1360-1361
Pooled RCTs: Atorvastatin did not increase renal-related serious adverse events
Annals of Internal Medicine; 161 (8): JC8
In older patients with hypertension, newly prescribed thiazides were linked to metabolic adverse events
Annals of Internal Medicine; 161 (8): JC11
Screening for Hepatocellular Carcinoma in Chronic Liver Disease: A Systematic Review
Annals of Internal Medicine; 161 (4): 261-269
View MoreView Less

Journal Club
Pooled RCTs: Atorvastatin did not increase renal-related serious adverse events
Annals of Internal Medicine; 161 (8): JC8
In older patients with hypertension, newly prescribed thiazides were linked to metabolic adverse events
Annals of Internal Medicine; 161 (8): JC11
View MoreView Less

Related Topics
Gastroenterology/Hepatology
Liver Disease

Gastroenterology/Hepatology, Liver Disease.

PubMed Articles
Viral Infection or IFN-α Alters Mitotic Spindle Orientation by Modulating Pericentrin Levels.
iScience 2019;
H2S inhalation-induced energy metabolism disturbance is involved in LPS mediated hepatocyte apoptosis through mitochondrial pathway.
Sci Total Environ 2019;
View More

Results provided by: PubMed

CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×